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Ask <br /> NOTE.- PULL ALL, _._-MITS (Septic, Well, etc.) MAKE MORPIES FOR FILE <br /> 1. SEWAGE: <br /> Distance to Public Sewers: �a�✓ Connection Necessary ? ❑ Yes Li No <br /> Does Existing Septic System comply with San Joaquin County Development Title? E] Yes ❑ No ❑ Unknown <br /> If no,explain: <br /> Describe Septic System to be installed: <br /> 2. WATER SUPPLY: <br /> Is Water supplied by Private Well ? D-Ves 0 No Is well properly sealed and constructed ? Yes F] No <br /> Describe deficiency,if any: <br /> Is well system a Public Water system ? r--] Yes E�J­No Is Public Water System Permit current? Yes No <br /> LIDoes existing or proposed use make this a Public Watct-System ? ❑ Yes No <br /> s water/well sampling current ? F-1Yes F-1No <br /> Additional information or comments: <br /> : <br />. 3. GARBAGE& REFUSE: <br /> Licensed scavenger pick-up? EI—Yes F-1 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 /> 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 /> :H 06 06 Report#7201 April 25,2007 <br />