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NOTE: PULL AL! ERMITS (Septic, Well, etc.) MAKL ,jPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Couuiectiou Ilecessary <br /> Does Existing Septic System comply with San Joaquin County Development Title ? F� Yes No Ej Unknown <br /> If no. explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? ©Wes 0 No Is well properly sealed and constructed ? E Yes F-] No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? ❑ Yes E�J'No is Public Water System Permit current? ❑ Yes No <br /> Does existing or proposed use make this a Public Water System ? F-1 Yes El No <br /> Is water/well sampling current ? F-] Yes F_� No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? Yes F-] 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: ��rr/oma l <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 /> 1 0606 Report,47201 April 09,2608 <br />