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� J <br /> 1. SEWAGE: cA �ecre� <br /> Distance to Public Sewers: �Xi S �,vConnection necessary: Yes No <br /> Does existing septic system comply with San Joaquin County Development Title RS F9 ? <br /> Yes No Unknown If no. explain: <br /> Describe septic installation to be installed: <br /> 2. WATER SUPPLY: -s"AA . <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 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 /> J. FLY, MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: ALIO dJo�Pd- <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: e�415-hy) Additional <br /> facilities needed: /)AC <br /> 6. PREVIOUS OPERATION HISTORY: <br /> C', �Y1VYU-1/ i �X <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: tjw p3d1e�, <br /> 8. POPULATION DENSITY: C <br /> Approximate number of people per square mile: C, �� Cylm(wl Gct ( G9A�� �L' irJv�L <br />