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1. SEWAGE: NOTE: LL, <br /> PULL ALRMITS (Septic, Well, etc.) MAKE PIES FOR FILE <br /> Distance to Public Sewers: Connection Necessary? ❑ Yes F-1 No <br /> Does Existing Septic System comply with San Joaquin County Development Title ? Yes No F-1 Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> w <br /> 1 <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? 0 Yes No Is well properly sealed and constructed ? Yes No <br /> Describe deficiency, if any: } <br /> Is well system a Public Water system ? 0 Yes No Is Public Water System Permit current? Yes No <br /> Does existing or proposed use make this a Public Water System ? 7 Yes F-1 No 1 <br /> Is water/well sampling current? E Yes No <br /> Additional information or comments: <br /> i <br /> i <br /> 3. GARBAGE&REFUSE: { <br /> Licensed scavenger pick-up? ❑ Yes 7 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: <br /> Number and Location(s)of existing facilities: <br /> Additional facilities required: <br /> I <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: I <br /> List any problem(s) not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: 1 <br /> H 06 06 Report#7201 July 24,2007 <br />