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e <br /> NOTE. PULL A ERMITS (Septic, Well, etc.) MAKLZOPIES FOR FILE <br /> I. SEWAGE: <br /> Distance to Public Sewers: Connection Necessary ? ❑ Yes ❑ No <br /> Does Existing Septic System comply with San Joaquin County Development Title? ❑ Yes <br /> If no,explain: ❑ No Unknown <br />' Describe Septic System to be installed: <br />'G 2• WATER SUPPLY: <br /> Is Water supplied by Private Well ? Yes No Is well properly sealed and constructed . Yes <br /> No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system? ❑ Yes ❑ 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/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 MOS UITO OR VECTOR CONTROL. <br /> Describe potential Vector Control issues: <br /> 5. 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 <br /> EH 06 06 Report#7201 <br /> August 20,2010 <br />