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NOTE., PULL ALL cRMITS (Septic, Well, etc.) MAKE )PIES FOR FILE <br /> SEWAGE: <br /> Distance to Public Sewers: Connection Necessary ? Yes No <br /> Does Existing Septic System comply with San Juayuin County Development Title ? Yes No Unknown <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> ATE SUPPLY: <br /> Is Water supplied by Private Well ? ewes F_� No Is well properly sealed and constructed ? Yes N�. <br /> Describe deficiency, if any: <br /> Is well system a Public Water system L I—I YesIs Public Water System Permit current ? E] Yes El No <br /> Does existing or proposed use make this a Public Water System ? F-1 Yes F-1 No <br /> Is water/well sampling current ? ❑ Yes No <br /> Additional information or comments: <br /> 3. GARBAGE d REFUSE: <br /> Licensed scavenger pick-up? Yes ED Vo Service Area No. <br /> O[her proposed disposal method: <br /> tential Problem(s): <br /> Y,MOS_OUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> ILET/BATH FACILITIES: /1 <br /> Number and Location(s)of existing facilities: <br /> Additional facilities required: <br /> PREVIOUS OPERATION HISTORY: <br /> GENERAL SANITATION: <br /> Lisl an% problem(s) not previously noted: <br /> POPULATION DENSITY: <br /> roximate number of people per square mile: <br /> i1G Report x7]01 brptember"<i. 7:p�g <br />