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NOTE: PULL ALL RMITS (Septic, Well, etc.) MAKE , PIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: ��A- Connection Necessary? E] Yes No <br /> Does Existing Septic System comply with San Joaquin County Development Title? Yes E] No dUnknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> ' 31 <br /> WATER SUPPLY: <br /> Is Water supplied by Private Well ? EZ Yes E] No Is well properly sealed and constructed ? Yes No <br /> Describe deficiency, if any: <br /> Is well system a Public Water system ? ❑ Yes [Z No Is Public Water System Permit current? Yes No - <br /> Does existing or proposed use make this a Public Water System ? ❑ Yes 2,No <br /> Is water/well sampling current ? [—] Yes F-] No <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE: r-�� <br /> Licensed scavenger pick-up? u 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: ZIA <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Location(s)of existing facilities: v ZZs <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: �J. �ij�i <br /> 3H 06 06 Report#7201 November 08,2007 <br />