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1. SEWAGE: <br /> Distance to Public Sewers: ;1 „� Connection necessary: Yes No <br /> Does existing septic system coml.l. with San Joaquin County Development Title #549 ? <br /> Yes No Unknown If no, explain: _ <br /> Describe septic nstallgtion to be installed: <br /> 2. WATER SUPPLY: <br /> Is water supplied by private well: Yes` No Is well proper: Yes Noy— <br /> State deficiency: �e _ _rT a 7'Is <br /> Is well system a Public Water system? Yes Nom— 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 r 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 /> 'iC " !f. i�Yu. /G"p5p/.-ter <br /> i <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: &ce cazG, Additional <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: 3r_ ' <br />