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Wed, <br /> NOTE: PULL HERMITS (Septic, Weil, etc.)' M,,,,,WL:OPIES FOR FILE <br /> I. SEWAGE: <br /> Distance to Public Sewers:_ /��,� Connection Necessary ? [--] Yes []J--No <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? M Yes ❑ No Is well properly sealed and constructed ? Yes No <br /> Describe <br /> ed�deficiency,if any: <br /> 67-7 C _ i _... <br /> Is well system a Public Water system ? F-] Yes M No Is Public Water Syst m Permit current ? Yes No <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes ENo <br /> Is water/well sampling current? F—] Yes No <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up? EA4 Ycs ❑ 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: I <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 /> t <br /> Approximate number of people per square mile: <br /> I'H 06 06 Report 117201 <br /> April 22,2008 <br />