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NOTE: PULL ALL—PERMITS (Septic, Well, etc.) MAKE--OPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: ;> Connection Necessary ? F� Yes No <br /> Does Existing Septic System comply with San ,Joaquin County Development Title? Yes No unknoNs n <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> ?• WATER SUPPLY: <br /> Is Water supplied by Private Well ? [::] Yes 0 No Is well properly sealed and constructed ? 0 Yes ❑ No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? F_� Yes F-1 No is Public Water System Permit current ^ ❑ Yes Ej No <br /> Does existing or proposed use make this a Public Water System ? El Yes No <br /> Is water/well sampling current? ❑ Yes �7 No <br /> Additional information or comments: <br /> 3• GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? EYes F—] No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> A. FLY,MOSQUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> +. TOILET/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 /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> I�H 06 W,Report=7201 <br /> !uh 14,2008 <br /> s <br /> �f <br /> v <br /> aAn <br /> O ' <br /> 00 <br /> 14 r <br /> W Q , <br /> 0 70 <br /> (0 m <br /> Q IL ... <br /> Q I^ e <br /> 16, <br /> F <br /> v <br /> v <br /> a <br /> �o ) <br /> U1+1 <br /> Z 1 — <br /> F two'.-, f,Rft. <br /> P/ Fzftcl. <br /> w E.y,1 i <br />