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NOTE: PULL AL RMITS (Septic, Well, etc.) MAKE-wj4PIES FOR FILE <br /> I. SEWAGE: <br /> Distance to Public Sewers: _ �r1;�� Connection Necessary? 'F� Yes No <br /> Does Existing Septic System comply with San Joaquin County Development Title? 0-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? D—Yes ❑ No Is well properly sealed and constructed ? E'Yes Ej No <br /> Describe deficiency,if any: <br /> Is <br /> Does ll system a Public Water system ?exisiing or proposed use make this a�Public WYes ater System No I? F1Public1Water System Permit current? E] r-Yes F-1No <br /> Is water/well sampling current? F-1Yes ❑ No ❑ <br /> Additional information or comments: <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? L_ i" ❑ 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 /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> FH 06 06 Report#7201 October 06,2008 <br />