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NOTE. PULL A 'ERMITS (Septic,Well, etc.) MAK <br /> ►COPIES FOR FILE <br /> i-� <br /> I. SEWAGE: <br /> Distance to Public Sewers:_ Connection Necessary? ❑ Yes 2"'No <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes F-1 No Ej Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? F-1 Yes E] No Is well property sealed and constructed ? ❑ Yes ❑ No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? �es No Is Public Water System Permit current? F-] Yes ❑ No <br /> Does existing or proposed use make this a Public Water System ? F-� Yes ❑ No <br /> Is water{well sampling current? 0 Yes ❑ No <br /> Additional information or comments: <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? f E f ' es F-1 No Service Area No.: <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> 4. FLY,_MOSOUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> S. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: , . l <br /> Additional facilities required: <br /> h. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s)not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> EH 06 06 Report#7201 November 06,2009 <br />