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CD) <br /> L SEWAGE: <br /> `Distance-to Public Sewers: oRoo <br /> � 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 /> E <br /> 2. WATER SUPPLY: / <br /> Is water supplied by private well: Yes �JNo Is well proper: Yell 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: I <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, MOSOUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: z� -������' <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: Additional <br /> facilities needed: <br /> b. PREVIOUS OPERATION ISTORY: <br /> t�htc,Ci�.Go - <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: a <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: c�J <br /> EH 06 06 Rev 1199 <br />