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-� <br /> NOTE: PULL ALL;�p3RMITS (Septic, Well, etc.) MAKL,MES FOR FILE__ <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Connection Necessary ? ❑ Yes No <br /> Does Existing Septic System comply with San Joaquin County Development Title? ❑ Yes No EErunknown <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? Eg-Ves- ❑ No Is well properly sealed and constructed ? FZkYes ❑ No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system? Fj Yes EEI'No Is Public Water System Permit current? Yes Fj No <br /> Does existing or proposed use make this a Public Water System ? F-] Yes ❑ No <br /> Is water/well sampling current? n Yes ❑ No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? 9-Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s). <br /> 4. FLY,MOSQUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues:/ <br /> 5. TOILET/.BATH FACILITIES: <br /> Number and Location(s)of existing facilities: ilyd � <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted: Z22zz nf/z � <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: ,��)C� <br /> EH 06 06 Report 47201 October 20,2008 <br />