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, <br /> NOTE. PULL A4.,,,RMITS (Septic, Well, etc.) MAS PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Ralyr Connection Necessary ? ❑ Yes No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes ❑ No Unknown <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? Yes ❑ No Is well properly sealed and constructed ? 0-'Yes E] No <br /> 5 Describe deficiency,if any: <br /> Is well system a Public Water system ? F-] Yes 2`1�o Is Public Water System Permit current? Yes Ej 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 /> f <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? F4�es No Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> 4. FLY,MOS UITO OR VECTOR CONTROL: <br /> i Describe potential Vector Control issues: <br /> F <br /> S. 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: �r�y <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> Eli 06 06 Report 97241 December 29,2008 <br /> i <br />