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1. SEWAGE: <br /> Distance to`Public.SeWers: � 7� Connection necessary: Yes N <br /> 1 i,, , �-! <br /> Does existing' septic., system comply with San Joaquin County Development . Title 5 <br /> Yes No Unknowns If no, explain: <br /> Describe septic installatio to be installed: <br /> 2. WATER SUPPLY: <br /> Is water supplied by private well: Yes 4----N—o Is well proper: Yes �No <br /> State deficiency: <br /> Is well system a Public Water system? Yes—X 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: <br /> 5. TOILET/BATH 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: <br /> Approximate number of people per square mile: ow <br />