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NOTE; PULL ALR RMITS (Septic, Well, etc.) MAKF"-9PIES FOR FILE ' <br /> I. SEWAGE: NW <br /> Distance to Public Sewers: Cb' Connection Necessary ? 0iYes F] No <br /> Does Existing Septic System comply with San Joaquin County Development Title? ®des ❑ No E] Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: -/zif �� <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? ®--Yes F] No Is well properly sealed and constructed ? E-ves Ej No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system? -i-Yes ED No Is Public Water System Permit current? 0 Yes E] No <br /> Does existing or proposed use make this a Public Water System ? F—] Yes No <br /> Is water/well sampling current? F-1 Yes F-1 No <br /> Additional information or comments: <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? �s ❑ 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 I 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 /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> EH 06 06 Report#7201 April 27,2009 <br />