Laserfiche WebLink
NOTE: PULL ALLS. ZRMITS (Septic, Well, etc.) MAKL—JOPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: i ! ; Connection Necessary? Yes IM 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 ? [':]�]'es F-� No Is well properly sealed and constructed ? ,Ej Yes E] No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? F-� Yes L_Y No Is Public Water System Permit current ? Yes 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? ❑ Yes E3�`NNo Service Area No. <br /> Other proposed disposal method: <br /> Potential Problem(s): <br /> 4. FLY, MOSOUITO OR VECTOR CONTROL: <br /> Describe potential Vector Control issues: <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> �c <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted `-�_� i-r_✓.�,-y /�yrs-=�,.,.i l/ <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> EH 06 06 Repon#7201 Page 2 lune 21,2004 <br />