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1. SEWAGE: <br /> Distance to Public Sewers: Connection necessary: Yes Noy. <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: — }.:� '�.t ,� ✓ , `� ! _,� / ✓�'Gf `��vy, �a/ <br /> Is water supplied by private well: Yes Is well proper: Yes L-- No <br /> State deficiency: <br /> Is well system a Public Water system? Yes No_C,,::�'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: of <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERAT ON HISTORY: j <br /> 7. GENE"problems <br /> TI N: <br /> State areviously noted: <br /> oh� 04 <br /> 8. POPULATION DENSITY: 4e r <br /> Approximate number ofer le eo square mile: <br /> P P P q <br /> ..- <br />