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d <br /> 1. SEWAGE: 10 ' <br /> Distance to Public Sewers: tiKfLT7 n b 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:?Ut 6 (—, `G-( W o�'�-- <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 04' 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: �xi 0 A-,C <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: �� { s _ Additional <br /> facilities needed: <br /> G. PREVIOUS OPERATION HISTORY: ''A�•• <br /> h ll�a� 1!4`�!/Lt <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: S�c�O <br />