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t I <br /> NOTE: PULL A*,,A PERMITS (Septic, Well, etc.) MA*0-60PIES FOR FILE <br /> 1. SEWAGE: _. <br /> Distance to Public Sewers: AA Connection Necessary ? 0 Yes F—] No <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes No 2�Unkuown <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? dYes ❑ No Is well properly sealed and constructed ? Yes [Z No <br /> Describe deficiency,if any: A,e)&4-- Lcl/-/IC�1!z►L/*Z: Z ,/j�c G � <br /> Is well system a Public Water system ? ❑ Yes No Is Public Water System Permit current? ❑ Yes ❑ No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes E�f No <br /> Is water/well sampling current ? ❑ Yes No <br /> Additional information or comments: <br /> 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? dyes E] 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 /> S. TOILET/BATH FACILITIES: <br /> Number and Location(s)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 /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> ;4 06 06 Report#7201 April 09,2008 <br />