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1. SEWAGE: <br /> Distance to Public Sewers: Connection necessary: Yes No�--- <br /> Does existing septic system comply with San Joaquin County Development Title #549 ? <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 Is well proper: Yes��1_ 0 <br /> State deficiency: <br /> Is well system a Public Water system? Yes No --r— Is the permit current? Yes Nom_ <br /> Does existing or proposed use make this well Public Water: Yes Nowater/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 /> Porit�lL� fG`�� <br /> 5 c <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary yccontrol: <br /> 5. TOILET/BATH FACILITIES: <br /> Number and locations existing: Additional <br /> facilities needed: <br /> 6. PREVIOUN OPERATION HISTORY: Jf <br /> r +/ <br /> r <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximateriuinu'to people per square mile: <br /> s <br /> 1 <br />