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r <br /> NOTE: PULL ALL4 RMITS (Septic, Well, etc.) MAKE PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: �� Connection Necessary? E-1 Yes 1�No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes No Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> t <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? Yes F] No Is well properly sealed and constructed ? Eiryes E:] No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? F-1 Yes [Z No Is Public Water System Permit current? Yes No <br /> Does existing or proposed use make this a Public Water System ? F1 Yes ©'No <br /> Is water/well sampling current? F–] Yes 7 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: <br /> 5. TOILET 1 BATH FACILITIES: <br /> Number and Location(s)of existing facilities: ti GQ Z2.r'7 <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted: /04 <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: —(/ zewl <br /> EH 06 06 Report#7201 February 15,2007 <br />