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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 /> Dept ++ o 6e insta c. 1 <br /> CZV <br /> 002 ed <br /> ` 1 r <br /> 2. WATER SUPPLY: <br /> Is water supplied by private well: Yes No Is well proper: Yes /o <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 a,�v ter/well <br /> samplin current:Nes No Additional information or comments: - litl�J� <br /> 3. GARBAGE & REFUSE: ��--- <br /> Licensed scavenger pick-up: Yes �No Service Area No.: �--Me-rZ�l <br /> osrd <br /> disposal method: <br /> Potential problem(s): <br /> 4. FLY, MOSQUITO 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: �r <br /> Approximate number of people per square mile: <br /> oZ r - ✓ <br /> ,� 02,� �� � <br />