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NOTE: PULL AL <br />ITS (Septic, Well, etc.) MAKE PIES FOR FILE <br />]. SEWAGE: No <br />�-!OD � Connection Necessary ? Yes <br />Distance to Public Sewers: ❑ Yes r-� No Q t)nknowu <br />%Kith San Joaquin County Developrttent'risle . <br />Does Existing Septic System comply LJ <br />if no, explain: . s'c%GlJ�5 �r <br />Describe Septic Systcm to be installed: <br />2. WATE12 SLIPPLY: <br />is Water supplied by Private Well? 0 Yes No <br />Describe deficiency, if any: <br />Is well properly scaled and constructed'! 0 Yes F� NO <br />Is well system a Public Water system ° � Yes <br />No Is Public Water System Permit current? <br />Q Yes Q No <br />Does existing or proposed use make this a Public ter System" Ycs \o <br />Is water / well sampling current ? F-1 l'cs D No <br />Additional information or comments: <br />3. GARBAGE & REFUSE: <br />,� No <br />Licensed scavenger pick-up.? Yes <br />Other proposed disposal method: <br />Potential Probletn(s): <br />:`rte <br />4. Ft.Y. MOS tJITO OR VECTOR CONTROL.: <br />Describe potential Vector Control issues: G';✓'� <br />Service Area No. : <br />5. TOILET / BATH FACILITIES: <br />Number and Locations 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 />4114 <br />8. POPULATION DENSITY: <br />Approximate number of people per square mile: <br />EH 00 06 Retx,rt:!7201 <br />r-.4 <br />Nlay 18, 21V <br />