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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 velopment Title #549 ? <br /> Yes No Unknown If no, explain: <br /> Describe septic installation to be installed: <br /> 2. WATER SUPPLY: <br /> Is water supplied by private well: Yes�o Is well proper: Ye 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- .f v s <br /> Q <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes No Service Area No.: Other proposed <br /> disposal method: <br /> Potential s <br /> s� q <br /> 4. FLY MOS U CTOR POTENTIAL: <br /> State ssr le vector potential and necessary control: r <br /> 5. TOILETBATH FACILITIES: Additional <br /> Number and locations existing: <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: Cope Manuracturing company <br /> 20400 N. Keanerick Rd. <br /> Approximate number of people per square mile: O T e Acampo, CA 95220 <br /> Y 209-334-1999Voice <br /> 109-368-0645Fex <br /> World leader In Begun & Mfg. for over <br /> S Years <br /> ll waM n <br />