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lort <br /> 1. SEWAGE: I18 z . <br /> Distance to Public Sewers: Connection necessary: Yes L- ' No <br /> Does existing septic system comply 'with San Joaquin County Development Title #549 ? <br /> Yes No Unknown - If no, explain: <br /> De be <br /> 2. WATER SUPPLY: r <br /> Is water supplied by private well: Yes 1/ No Is well proper: Yes__ZZNo <br /> State deficiency: <br /> Is well system a Public Water system? Yes Nos <br /> the permit current? Yes No <br /> Does existing or proposed use make this well PublicVa7t-er- Yes Nois water/well <br /> sampling current: yes No Additional information or comments: 7 4_0 <br /> 3. GARBAGE FUSE: /'/ ,d f�. �„rG Ao,r <br /> Licensed scavenger pick-up: Yes No Service Area No.- Other proposed <br /> disposal method: <br /> PoVxna probe (s): <br /> 4. FLY, MOSQUITO OR VECTOR-PUTI NTIAL: <br /> State pos9ib1e­ver r potential and neces ry control: <br /> CAL <br /> 5. TOILET/BATH FACILITIES: <br /> Number and locations existing: _ Additional <br /> facilities needed: <br /> 6. PREVIOUS OERATIO HISTORY: <br /> ,t e+ <br /> 7. GENERAL SANITATION: . <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />