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I. SEWAGE: <br /> Distance to Public Sewers- Clay! 1 Connection necessary: Yes No <br /> Does existing septic s stem comply with San Joaquin County Development , Title 9549 ? <br /> Yes No Unknown If no, explain: <br /> Describe septic installation to be installed: G A"a <br /> 2. <br /> WATER SUPPLY: /vU l '� ' � IZZIAZ <br /> Is water supplied by private well: Yes No ✓ s Is well proper: Yes No <br /> State deficiency: e4- 1 <br /> Is well system a Public Water system? Yes No Is the permit current? Yes No <br /> Does 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 /> -- No Service Area No.: Other proposed <br /> Licensed scavenger pick-up: Yes <br /> disposal method: <br /> Potential prob! m(s): Go <br /> 4. FLY MOS UITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: A14 <br /> t - <br /> 5. TOILETBATH FACILITIES: Additional <br /> Number and locations existing: <br /> facilities needed: v <br /> 6. PREVIOUS OPERATION HISTORY: <br /> h l S .s9 <br /> a <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />