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NOTE: PULL ALL RMITS (Septic, Well, etc.) MAKE NOO PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: N Connection Necessary? ❑ Yes No <br /> Does Existing Septic System comply with San Joaquin County Development Title? d Yes 0 No F] Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? dyes ❑ No Is well properly sealed and constructed ? dYes F] No <br /> Describe deficiency,if any: <br /> Is well system" <br /> Publ' ater system ? Yes 0 No Is Public Water System Permit current ? Yes 0 No <br /> Does existin pro�lnlgcurrent <br /> d use make this a Public Water System ? ❑ Yes No <br /> Is water/we ? ❑ Yes ❑ No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? Er 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: . �- C <br /> 5. 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 /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> 1106 06 Report#7201 June 13,2007 <br />