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1. SEWAGE: ,,I <br /> Distance to Public Sewers: °V 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: /V6 W Sy57T6M 1Ay741.CE i::) .14N 200M <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 No Is water/well <br /> sampling 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 /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: DR,9rNA&<- L>(7`,fH C QossEsPRo�6c�� <br /> 5. TOILET/BATH FACILITIES: <br /> Number and locations existing: — 10V 544Es r3 u 11.D 1A)6. Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: IJ oN� <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: R U�'�� Z&5 l-envr 14 L <br />