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1. SEWAGE: <br /> Distance to Public Sewers: e—leeConnection 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: 7*.$4iG 5 &V- Zd BcT/rlil0 :/f 4*j4EL&K <br /> NaS SPG?G!/l.6Si�E3tLcf4ecJ Zfi�L .s7� S�1ic Z'br>r !S !e Ait-5 <br /> 2. WATER SUPPLY: <br /> Is water supplied by private well: Yes No Is well proper: Yes ✓ 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 wafer/well <br /> sampling current: yes No Additional information or comments: 4&47 <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, MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: A11- <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: e2 //1 — .4: Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> E��,ecnf�i <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: L4.Cl—_t�t� 2 . <br /> EH 0606 Rev 1/99 <br />