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1. SEWAGE: <br /> Distance to Public Sewers: /V 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: <br /> Is water supplied by private well: Yes No Is well proper: Yes No <br /> State deficiency: <br /> Is well system a Public Water system? Yes No Is the permit curr nt? Yes No <br /> Does existing or proposed use make this wellubl <br /> Pic Water: Yes No Y Is water/well <br /> sampling current: yes No Additional information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes NoService Area No.: Other proposed <br /> disposal method: <br /> Potential problem(s): <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: ry 3REt1>NiT' QREc)rer.'rp <br /> State possible vector potential and necessary control: <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: I#v Iyv~S Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY- <br /> t3/}A) l"fDIAA'F5 m 4r im N PAST — A10 /9?2 S V?X <br /> 7. GENERAL SANITATION: I i <br /> State any problems not previously noted: H fou d w472R– 14*1,,L S AIF72`S�u+li <br /> FGcST Ot7�CZ5 FIND £h� S vFaQ NEW t9RGe CNGC@11 <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />