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NOTE: PULL iL)PERMITS (Septic, Well, etc,) MA,,-J FOR FILE _ <br /> I. SEWAGE: <br /> Distance to Public Sewers: JV1 Connection Necessary ? Yes No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes No <br /> 5�49- <br /> If no, explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? ❑ Yes EZNo Is well properly sealed and constructed ? ❑ Yes ❑ No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? ❑ Yes ❑ No Is Public Water System Permit current? ❑ Yes F-1 No <br /> Does existing or proposed use make this a Public Water System ? 0 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 E]eNo Service Area No. <br /> Other proposed disposal method: <br /> Potential Probiem(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: 6t3Ni . <br /> FH 06 06 Report 47201 April 09,2008 <br />