Laserfiche WebLink
NOTE: PULL ALL F`— MITE (Septic, Well, etc.) MAKE eWPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: L ZQJ" Connection Necessary? E; Yes F-1 No <br /> f <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes r-1 No F-] Urn <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? ❑ Yes 2" No Is well properly sealed and constructed ? Yes E] No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? F-1 Yes r-� No Is Public Water System Permit current? 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-] No <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up. Yes 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: eJ- <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 />-H 06 06 Report#7201 May 08,2007 <br />