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Y <br /> 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 /> O <br /> 2. WATER SUPPLY: A d 1,,Z jz7es'�, <br /> Is water supplied by rivate well: Yes 0 Ao Irwell proper: No <br /> State deficiency: <br /> Is well system a Public Water system? Yes No Is the permit current?Yes' ' N6 ' <br /> Dbes existing o'r`pfopOsed use makL-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: 01! <br /> a_.� -)Oi- -o—,>i <br /> L <br /> 5. TOILETjMn FACILITIES: / <br /> Number a locations existing: T' C� 2. /l:s f Additional <br /> faciliti�ee ed: �..� <br /> 6. PREVIOUS OPERATION HISTO Y: <br /> 2 <br /> 7. GENERAL SANITATION: L,) <br /> & <br /> State any problems not previously note: cc- <br /> y gym <br /> 8. POPULATION DENSITY: 1 y J <br /> Approximate number of people per square mile: �``` <br />