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1. leAj <br /> SEWAGE- <br /> Distance to Public Sewers: L C Sop D .T- 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 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 existing or proposed use make this well Public Water: Yes No Is water/well <br /> sampling current: yes No Additional information or c mments: ; LS <br /> 1 <br /> 3. GARBAGE & REFUSE: �r r <br /> Licensed scavenger pick-up: Yes No Service Area No.: �rp?ropose ' <br /> disposal method: <br /> Potential problem(s): <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL: <br /> ! State possible vector potential and necessary control: <br />.I <br /> - 5. TOILET/BATH FACILITIES: <br /> Number and locations existing: �/� Additional <br /> facilities needed: <br /> . 1 <br /> 6. PREVIOUS OPERATION HISTOR <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />