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� (Septic, , MAKE `,PIES FOR FILE <br /> NOTE: PULL ALL ' ZMITSWeII .,efc.] <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Connection Necessary ? ❑ Yes Ei�No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? ❑ Yes E� No Unknown <br /> If no,explain:_ � �= t�1li/Hi19G -- <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well? Yes F] No Is well properly sealed and constructed ? D/Yes 13/No <br /> Describe deficiency,if any: ��.Z <br /> Is well system a Public Water system ? ❑ Yes [R 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? F-1 Yes ❑ No <br /> Additional information or comments: <br /> 3. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? d 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: 44 <br /> 5. TOILET 1 BATH FACILITIES: <br /> Number and Location(s) of existing facilities: ti l���J � �ya✓ / � <br /> Additional facilities required: <br /> b. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> List any problem(s) not previously noted: AA <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> Eli 06 06 Report 47201 June 12,2007 <br />