Laserfiche WebLink
NOTE: PULL ALL_ .RMITS (Septic, Well, etc.) MAKE -)PIES FOR FILE <br /> 1. SEWAGE: f <br /> Distance to Public Sewers: L[t2 Connection Necessary ? �Yes No ���� <br /> 1�nlerie�r <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 ? F_� Yes 5� No Is well properly sealed and constructed ? Yes 0 No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? F] Yes 7 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 ? F-1 Yes F-1 No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? Yes Ej 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: <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 /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> EH O6 06 Report 47201 August 14,2� <br />