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NOTE: PULL ALL`:RMITS (Septic, Well, etc.) MAKE „)PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: [� Connection Necessary ? ❑ Yes Eg/No <br /> Does Existing Septic System comply with San Joaquin County Development 'I itle ? Yes No Iyx1 x <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> `SUPPLY: <br /> Is Water supplied by Private Well ? Yes d No Is well properly sealed and constructed ? Yes No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? Yep No is Public Wafer System Permit current ? Yes No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes F—] No <br /> Is water/well sampling current ? ❑ Yes F1 No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? ❑ Yes No Service Area No. <br /> Other proposed disposal method: <br /> tential Problem(s): <br /> Y, MOSQUITO OR VECTOR CONTROL: <br /> critic potential Vector Control issues: _44 <br /> ILET/ BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br /> 9dditional facilities required: <br /> PREVIOUS OPERATION HISTORY: <br /> GENERAL SANITATION: <br /> List anv problem(s) not previously noted: <br /> PULATION DENSITY: <br /> ate number or people per square mile <br /> #7201 Uc�oMcr 20,20", <br />