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NOTE: PULL ALL l' LIMITS (Septic, Well, etc.) MAKE (,,,,CIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: � a�' Connection Necessary? ❑ Yes allo <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes ❑ No Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> i <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? L3_V-6- ❑ No Is well properly sealed and constructed ? Yes No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? E] Yes 4D 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 1 well sampling current ? Ej Yes ❑ No <br /> Additional information or comments: <br />{1 � <br /> 1 � <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: syn �tio� <br /> S. 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 /> i <br /> EH 06 06 Report#7201 December 26,2007 <br /> r.. - <br />