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��3 G C) - <br /> 4 f <br /> S00e Z . 32 <br /> y� A <br /> 1. SEWAGE: j-rs--ir—O rS <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 /> � .,� - 96 2- G <br /> 2. WATER SUPPLY: ?'.a 3 u _ Y5 <br /> Is water supplied by private well: Yes L-;� No Is well proper: Yes No <br /> State deficiency: <br /> ZrAfg GP <br /> Is well syst a Public Water system?Y-es------ . Is the permit current? Yes <br /> Does existing or proposed use make this well Public Water: Yes Na *Is water/well <br /> s�� <br /> sampling current: yes No Additional information or comments: M p—.0 <br /> 3. ARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes No Service Area No.: Other proposed <br /> disposal method: <br /> Potential problern(s): <br /> 4. 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 HISTORY: <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />