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NOTE: PULL ALL RMITS (Septic, Well, etc. <br /> 1. ) MAKE PIES FOR FILE <br /> SEWAGE: <br /> Distance to Public Sewers: >Za a /=, Connection Necessary ? 0 Yes Q--No <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes No <br /> If no,explain: Unknown <br /> Describe Septic System to be installed: J c yt e {c <br /> K -Ya�2- (o <br /> 2. WATER SUPPLY: <br /> u�.�c.R,uu,✓ Gµcc�� <br /> Is Water supplied by Private Well ? [D Yes No Is well properly sealed and constructed ? Yes No rrEcL <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? E] Yes allo Is Public Water System Permit current ? ❑ Yes No N/4 <br /> Does existing or proposed use make this a Public Water System ? F-1 Yes ❑ No <br /> Is water/well sampling current? E] Yes [--] No y,IA <br /> Additional information or comments: £rt�ir��-./ (- LJEa.es �-cwST e yes'r�oy E,p <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? 0 Yes r-1 No Service Area No. <br /> Other proposed disposal method: <br /> PotentialProblem(s): �E,>-ior,.Tlo,a .����t,tS E�:Sri <br /> 4. FLY, MOSQUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br /> — <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> )Pf S , O E.vT � �L-L- <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 />:H O6 06 Report#7201 May I7,2006 <br />