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NOTE: PULL AL., .HERMITS (Septic, Well, etc.) MAKE:OPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Y Connection Necessary ? Yes 2-`&0 <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes No �j�Unknown <br /> 1f no,explain: <br /> Describe Septic System to be installed: <br /> WATER SUPPLY: <br /> Is Water supplied by Private Well ? ��Ves ❑ No Is well properly sealed and constructed ? !]'Tes D No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? ❑ Yes F-] 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 ? ❑ Yes F-1 No A r <br /> Additional information or comments: T -��}��/ .� N-r r-s.� �6✓S <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? E9--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 /> �. <br /> TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted: <br /> POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> 06 06 Report#7201 June'0. 201)s <br />