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s �1. SEWAGE: Ci b3 9 3 <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: ��f �F <br /> ied b private well: Yes N7o Is well proper: Yes , No <br /> Is water supply y p <br /> St e defic' Z *- <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 /> Licensed scavenger pick-up: Yes No Service Area No.: Other proposed <br /> disposal method: <br /> Potential problem(s): <br /> 4. FLY MOS UITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: / + <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: .J <br /> Approximate number of people per square mile: <br /> X J <br /> w r e <br />