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- — NOTE: PULL ALI. ERMNTS (Septic, Well, etc.) MAKL-COPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Connection Necessary ? F-1 Yes F-] No <br /> Does Existing Septic System comply with San.Icaquin County Development Title? F_� Yes f—] No 1'nkii,m it <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLI': <br /> Is Water supplied by Private Well ? F-1 Yes 0 No Is well properly sealed and constructed ? [] Yes No <br /> Describe deficiency. if any: <br /> Is well system a Public Water system ? F-1 Ye-: F-1 No Is Public Water System Permit current? El Yes No <br /> Does existing or proposed use make this a Public Water System? F-1 Yes F_� No <br /> Is water/well sampling current? F—] Yes F__j No <br /> Additional information or comments: <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? M Yes F—] 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: <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 /> FI1 06 06 Report 97201 <br />