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1. SEWAGE: FfTN'A mot Molo'le 4►c'F ply FGuv1d , �oN� ��ettous� <br /> Distance to Public Sewers: 0 Connection necessary: Yes No X <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: Fpm ti *X 6r;sv"6,_ wi"GL e2trr7- IVOV-6 fF4C— <br /> Is water supplied by private well: Yes `� No Is well proper: Yes No <br /> State deficiency: /11Z__lrx <br /> P <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 .f 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 problem(s): <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: 6%ne_'x� ( <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: - " Jc, bnt 11 Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: lyewc <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> i <br />