Laserfiche WebLink
NOTE: PULL ALL .MITS (Septic, Well, etc.) MAKE CIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: 07! '" Connection Necessary ? ❑ Yes No <br /> Does Existing Septic System comply with San Joaquin County Development Title? E/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 ? Q Yes ❑ No Is well properly sealed and constructed ? E[ Yes E] No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? ❑ Yes ©- No Is Public Water System Permit current ? E] Yes 0 No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes ❑ No <br /> Is water/well sampling current ? ❑ Yes ❑ No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? ❑ ❑ 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/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: ,rtG's. �/ <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: A <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 07201 February 15,2006 <br />