Laserfiche WebLink
NOTE: PULL ALL' �. RMITS (Septic, Well, etc.) MAKEv.,04PIE3 FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Fcr� Connection Necessary? ❑ Yes AE] No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes No Er 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 ? ❑ Yes Zr"No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? ❑ Yes No Is Public Water System Permit current? F-� Yes E] No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes No <br /> Is water/well sampling current? F-] Yes No <br /> Additional information or comments: <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? F7_N-es ❑ No Service Area No. <br /> Other proposed disposal method.- <br /> Potential <br /> ethod:Potential Problem(s): <br /> 4. FLY MOSQUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> S. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> ILI <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: :L�7 <br /> :F106 06 Report 47201 March 13,2007 <br />