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y } <br /> NOTE: PULL ALL ..RMITS (Septic, Well, etc.) €,';,. :°;lr t{ Pit.'` <br /> 1. SEWAGE: _ <br /> Distance to Public Sewers: ��� � Connection Necessary ? Yes &No <br /> Does Existing Septic System comply with San Joaquin County Development Title '? El Yus No . �Jnknown ; <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Nater supplied by Private Well ? es Nn Is well proper]., scAcd ,i,ILi construcic!d ? E' Yes Ej No <br /> Describe deficiency, if any: _ <br /> _ I <br /> Is well system a Public Water system ? Yes ❑ No Is Public Water._�yslem 1'vrl:.;' : t " C' Yes No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes f] No <br /> Is water/well sampling current ? F1Yes F No <br /> Additional information or comments: <br /> 3. GARBAGE, ,c REFUSE: <br /> Lice nscd scavenger pick-up? fft Yes F-1 No Service Area No. : <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> 4. FLY MOS tJTTO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> 5. TO'U'T/11,'.1-11 FACILITIES: <br /> Numbcr and Locatiou(s) of existing facilities: <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> I <br /> I <br /> I <br /> 7. GENERAL SANITATION: <br /> I <br /> List any prohlem(s) not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> EN 06 06 Report 47201 August 14,2006 <br />