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NOTE: PULL ALL MMITS (Septic, Well, etc.) MAKE JPIES FOR FILE <br /> 1. SEWAGE: P-t'ect.< :_E , -t <br /> Distance to Public Sewers: ,; ,�` ,� yj�_—i&onnection Necessary ? f—] YesF-1No <br /> Does Existing Septic System c opiy with San Joaquin Count.NDevelopment Title ? Fj Yes F No ❑ Unknown <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? F-1 Yes Ej No Is well properly sealed and constructed ? ❑ Yes E] No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? F-] Yes F_� No Is Public Water System Permit current? F-] Yes No <br /> Does existing or proposed use make this a Public Water System ? F-1 Yes F-] No <br /> Is water/well sampling current ? ❑ Yes F-1 No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? []3 Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> 4. FLY,MOSOUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: `/4L: C ' <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: f�f✓SY fZ _ <br /> EH 06 06 Report#7201 October 20,2008 <br />