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1. SEWAGE: <br /> Distance to Public Sewers: 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 /> /M z�r r <br /> 2. WATER SUPPLY: � r���irJ 507, <br /> Is water supplied by private well: Yes—� No Is well proper: Yes No <br /> St iency: �tJ (/ S /3 t' if r /.S <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/welJl <br /> sampling current: yes No Additional information or comments: S z aV <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes 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 /> 5. TOILETBATH FACILITIES: / <br /> Number and locations existing: Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: l <br /> M I/t/ ( 5 7-.1 V2. U fie <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: _ <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: _ <br />