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V. <br /> NOTE: PULL PERMITS (Septic, Well, etc.) MAs:OPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: � /� Connection Necessary? ❑ Yes E]lNo <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes F-� No ❑ Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2• WATER SUPPLY: <br /> Is Water supplied by Private Well? Yes ❑ No Is well properly sealed and constructed ?,EJ—Yes Ej No <br /> Describe deficiency,if any: eK <br /> Is well system a Public Water system ? ❑ Yes F No Is Public Water System Permit current? Yes No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes [--j No <br /> Is water/well sampling current? ❑ Yes F-1 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: Z <br /> 5. TOILET I BATH FACILITIES: <br /> Number and Location(s)of existing facilities: <br /> Additional facilities required: <br /> 6. PREVIOUS OPERATION HISTORY: ,�yy <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 97201 September 28,2005 <br />