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r <br />NOTE: PULL ALL LIMITS (Septic, Well, etc.) MAKE 1,,,31ES FOR FILE <br />1. SEWAGE: <br />Distance to Public Sewers:NConnection Necessary? Yes D/No <br />Does Existing Septic System comply with San Joaquin County Development Title ? [ZYes No Unknown <br />If no,explain: <br />Describe Septic System to be installed: <br />2. WATER SUPPLY: <br />Is Water supplied by Private Well?Yes No Is well properly scaled and constructed ?Yes E] No <br />Describe deficiency,if any: <br />Is well system a Public Water system ? Yes No Is Public Water Syst m Permit current? E] Yes No <br />Does existing or proposed use make this a Public Water System ? El Yes dNo <br />Is water/well sampling current? 7 Yes No <br />Additional information or comments: <br />3. GARBAGE&REFUSE: <br />Licensed scavenger pick-up? dyes r—] 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: li467-/ <br />Additional facilities required: <br />G. PREVIOUS OPERAT/ION 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 />EH 06 06 Report#7201 August 01,2006