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NOTE: PULL ALI 1RMITS (Septic, Well, etc.) MAKE._,)PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Connection Necessary? ❑ Yes E?"No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes No Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> V <br /> WATER SUPPLY: <br /> Is Water supplied by Private Well ? yz Yes 0 No Is well properly sealed and constructed ? Yes No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system . ❑ Yes [71 No Is Public Water System Permit current ? Yes No <br /> Does existing or proposed use make this a Public Water System? © Yes No <br /> Is water/well sampling current? El Yes F—] No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: I <br /> Licensed scavenger pick-up? F—] Ycs u No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> WSQUITO OR VECTOR CO VTROL: <br /> Vibential Vector Control issues: VIA <br /> . 'TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br /> Additional facilities required: <br /> :6. PREVIOUS OPERATION HISTORY <br /> �. GENERAL SANITATION: <br /> List any problem(s) not previously noted: 41-R <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> 147201 March 69.200,, <br />