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J iI i <br /> I. SEDGE: ted , <br /> Distance to Public Sewers: <br /> Does existingConnection necessary: <br /> Yes septic system comply with San Joaquin County eve opmen Title <br /> �� No�� Unknown 9 . <br /> �If no, explain: <br /> Describe septic installation to be installed: <br /> 2• WATER SUPPLY: <br /> Is water supplied by private well: Yes <br /> State deficiency: � NO Is well proper: yes�y No <br /> Is well system a Public Water system? Yes <br /> No <br /> Does existing or proposed use make this well Publ c Water: esthe permit current? Yes <br /> No <br /> sampling current: yes No Yes- Is water/well <br /> Additional information or comments: <br /> 3• GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes- No- Service Area No.: <br /> disposal method: Other proposed <br /> Potential problem(s): <br /> 4. FLY MOS UITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: <br /> 5. TOILET/BATH 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 /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />