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NOTE: PULL ALL MITS (Septic, Well, etc. M�I. SEWAGE; } CIES FOR FILE <br /> fDistance to Public Sewers: <br /> Connection Necessary? Yes <br /> Does Existing Septic System comply with San Joaquin County Development Title ? ❑ No <br /> If no,explain: © Yes ❑ No ❑ Unknown <br /> f Describe Septic System to be installed: <br />!I <br /> f <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? <br /> Yes ❑ No Is well properly sealed and constructed ? No <br /> Describe deficiency, if any: Yes <br /> Is well system a Public Water system ? yes <br /> No Does existing or proposed use make this 0 Ye Water System ?s PublicYes <br /> System Permit current ? <br /> Is water/well sampling current? ❑ Yes ❑ No <br /> ❑ Yes � ❑ No <br /> Additional information or comments: Na <br /> J. GARBAGE&REFUSE: <br /> Licensed scavenger pick-up? ❑ Yesf� No <br /> Other proposed disposal method: �J Service Area No. <br /> Potential Problem(s): <br /> 4. FLY MOS UITO 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 /> i. PREVIOUS OPERATION HISTORY: <br /> �t <br /> GENERAL SANITATION: <br /> List any problem(s)not previously noted: <br /> POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> 5 06 Report#7201 <br /> March 14,2006 <br />