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1. SEWAGE: <br /> Distance to Public Sewers: ow 5 4 Connection necessary: Yes u No <br /> .Does existing septic system comply with San Joaquin County Development . Title 4549 ? <br /> Yes No Unknown If no, explain: <br /> Describe septic installation to be installed: <br /> 2. WATER SUPPLY: <br /> Is water supplied by private well: Yes No Is well proper: Yes No <br /> State deficiency: <br /> Is well system a Public Water system? Yes No Is the permit current? Yes—No— <br /> Does <br /> esNoDoes existing or proposed use make this well Public Water: Yes No Is water/well <br /> sampling current: yes No Additional information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes No Service Area No.: Other proposed <br /> disposal method: <br /> Potential problems): <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: aetlE <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: I r f Additional <br /> facilities needed: 2 <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: out <br /> 8. POPULATION DENSITY: ��f « ��}G' �! T �' � <br /> Approximate number of people per square mile: <br />