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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 /> 2. WATER SUPPLY: <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__4,� No Is water/well <br /> sampling current: yes No Additional information or comments: ' E <br /> 4Z t&2 e / <br /> e i e <br /> 3. GARBAGE & REFUSE: / � �" <br /> S Wd-fc <br /> Licensed scavenger pick-up: Yes e---"No Service Area Ng.: 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. TOILET/BATH FACILITIES: <br /> Number and locations existing: Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> ���r 1.,.,Gi � u' S c� �► G <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: �— <br /> Approximate number of people per square mile: <br /> 7-11, <br /> 5 �- —?77 z-- <br />