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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 <br /> Yes No unknown b-1 If no. explain: 4' 49 ' 1 <br /> Describe septic installation to be installed: <br /> 2. WATER SUPPLY: /4!t) ����' <br /> Is water supplied by private well: Yes X No Is well proper: Yes No ,i� <br /> State deficiency: oY,*yd <br /> r5r�,Vkl1 <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: ves No Additional information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes No Service Area No.: Other proposed <br /> disposal method: L ��✓;: ' : t-' <br /> Potential problem(s): <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: N o n E AJp <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: �o��E�s f / urs r7w( (Z i <br />