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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 /> Describe septic installation to be installed: <br /> 2. WATER SUPPLY: el Fy a& 61too) 4L) <br /> Is water supplied by private well: Yes No X 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 water/well <br /> sampling current: yes No Additional information or comments: <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: uo v6- <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: IN 13u14J1n14 Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> (dHAA)o5 TuP S.F-i6lo <br /> 7. GENERAL SANITATION: '�y <br /> State any problems not previously noted: ^w Rt TIOW 12mf! /.w In "W Aa fktrr� <br /> � <br /> 1-4_f P4VED IOMk — 1.198,6E e3w�N6 SMAA1. kor Q' =zz <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />