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1. SEWAGE: N,9 <br /> Distance to Public Sewers: //lD'y-e- Connection necessary: Yes No <br /> Does existing septic system comply with San Joaquin County Development Title #549 ? <br /> Yes No Unknown If no, explain: A100e af-e5e*rr <br /> Describe septic installation to be installed: <br /> 2. WATER SUPPLY: I"�i4fiorr u�/Qir'SB-v>L—jNa 1.4, // hol �✓'"i{s <br /> Is water supplied by private w 1: Yes � No Is well proper: Yes No .i <br /> State deficiency: AlN� <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: Asi NO <br /> Potential problem(s): <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: N&Ie M.4 <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: //D i t-C- Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 1/ihf <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: ,cion E ,,y0 <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: R- <br />