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NOTE: PULL ALI` :RMITS (Septic, Well, etc.) MAKE _)PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: 7a� Connection Necessary ? Yes No <br /> Does Existing Septic System comph. with San Joaquin County Development Title ? Yes No el Unknown <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> WATER SUPPLY: <br /> Is Water supplied by Private Well ? LD_A�Es No Is well properly sealed and constructed ? 0�Yes D No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? ❑ Yes En'No Is Public Water System Permit current ? Yes No <br /> Does existing or proposed use make this a Public Water System ? E] Yes No <br /> Is water/well sampling current? M Yes No <br /> Additional information or comments: <br /> GARBAGE &REFUSE: <br /> Licensed scavenger pick-up? es 0 No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> FLY, MOSQUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> MOL— <br /> • TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: ii7i✓DfG <br /> Additional facilities required: <br /> • PREVIOUS OPERATION HISTORY: <br /> G - <br /> GENERAL SANITATION: <br /> List any problem(s) not previously noted: / nfryiLo�/ <br /> POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> 06 06 Rcpon#7201 April <br />