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1. SEWAGE: <br /> Distance to Public Sewers: S-Tk6�-_7` 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: 'f <br /> 2. WATER SUPPLY: <br /> Is water supplied by private well: Yes No �` _ Is well proper: Yes No <br /> State deficiency: kl%..) wE t-L <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 E 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: Nytie_- pRvPasEy Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> T- <br /> 7. <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: kZ�,,D5 6r - asp!fr�v'� <br /> A AJD('0A;e ktTL <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: /1'Wi2l[A M 1{0,�-t /440( 7b k*T7-fr <br />