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J <br /> l � � <br /> 1. SEWAGE: <br /> Distance to Public Sewers: Connection necessary: Yes No <br /> Does existing septic system comply with San Joaquin County Development Title 9549 ? <br /> Yes No Unknown If no. explain: <br /> Describe septic installation to be installed: <br /> (;J c/! VZ�t ,-, rT & - 3 y7 <br /> Z. WATER SUPPLY: / -7 5 4�_f ! 1 ,2d- ud Ci r <br /> Is water supplied by private well: Yes No Is well proper: Yes I/ No <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 water/well <br /> samplino current: yes No Additional information or comments: <br /> z 2 r <br /> T ti� <br /> 3. GARBAGE & REFUSE: %P/ <br /> Licensed scavenger pick-up: Yes No Service Area No.: Other proposed <br /> disposal method: <br /> Potential problem(s): <br /> J. 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 HISTO <br /> R <br /> / /jl/ off <br /> 7. GENERAL SANITATION: �Q.�1 re- T ! � � • I T Ty 7t/ �Y6 <br /> State any problems not previously noted: <br /> 8. POPULATION-DENSITY: <br /> U �`� f OriGQ,� �.s1� .�� ? L-O� <br /> Apprs:�imate uare�f»te-. <br /> 1) 4. V­o 2Lca`5S 70-U TA e <br />