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NOTES PULL ALL i YMITS (Septic, Well, etc.) MAKE ( 'IES FOR FILE <br /> 1. SF-WAGE: <br /> Distance to Public Sewers: /{�r Connection Necessary ? F__j Yes Ev'No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes No © n <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? 59 Yes Ef No Is well properly sealed and constructed ? ❑ Yes n No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? ❑ Yes 0 No Is Public Water System Permit current? ❑ Yes ❑ No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes ❑ No <br /> Is water 1 well sampling current ? ❑ Yes 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 /> Potential Problem(s): <br /> 4. FLY,MOSQUITO OR.VECTOR CONTROL: <br /> Describe potential Vector Control issues: /—Af <br /> S. TOILET 1 BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br /> Additional facilities required: <br /> 6. PitEVIOUS OPERATION HISTORY: <br /> _a__' . <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted: ,(JIA <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> i 1 06 06!,eport H 720 t April 09,2008 <br />