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1. SEWAGE: <br /> Distance to Public Sewers: Connection necessary: Yes <br /> Does existing septic system comply with San Joaquin County Development Title #549 <br /> Yes No Unknown L/ If no. explain: <br /> D % 7 <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: 1 <br /> Is well system a Public Water system? Yes No the permit current? Yes No <br /> Does existing or proposed use make this well Public Water: Yes No --Is water/well { <br /> sarppling 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 /> i <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary.control: i <br /> 5. TOILETBATH FACILITIES: ,--�" <br /> Number and locations existing: Additional <br /> facilities needed: <br /> 6. PREVIOU5 OPERATION HISTORY: r" <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />