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t• <br /> NOTE: PULL ALL ,,�RMITS (Septic, Well, etc.) MAKE,.j3PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Connection Necessary ? ❑ Yes 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 /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? Ej Yes 0 No Is well properly sealed and constructed ? Yes E] 'No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? M Yes F-1 No Is Public Water System Permit current ? Yes No <br /> Does existing or proposed use make this a Public Water System ? f7l Yes F-1 No <br /> Is water/well sampling current? F-] Yes F1 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: � � L - �, J(�� <br /> Z*11�,J-' 7� J� <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: uZZ— � ( �6y410 <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 /> EH 06 06 Report#7201 March 21,2008 <br />