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I. SEWAGE: <br /> Distance to Public Sewers: V( Ln L9w w Connection necessary: Yes No <br /> Does existing septic system comply with San Joaquin County Development Title #54 ? <br /> Yes No Unknown If no, explain: <br /> P" ,, I /To - # ry 03 3f9 <br /> Describe septic installation to be installed: <br /> 2. WATER SUPPLY: i jfn y <br /> Is water supplied by private well: YesZ No ✓ Is well proper: Yes No <br /> State deficiency: <br /> Is well system a Public Water system? Yes No Is the permitcurre t?Yes o <br /> Does existing or proposed use make this well Public ater: Yes NoIs water/well <br /> sampling current: yes No Additional information or comments: <br /> a <br /> e <br /> 4,.. ; r '.x .: a f , , `r r :�_ 4 4 S � .'t �, r ,. �i .4 a B t • � . r�'s 4 s ti . <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes No �;` Service ArealVo:: Other pzoposeci <br /> ".disposal method: 1 1, -- - - O ;i � <br /> Potential problem(s): ' <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: k <br /> State possible vector potentialan necessary contro <br /> 5. TOILET/BATH FACILITIES: / /�► <br /> Number and locations existing: &,,,0 Additional <br /> facilities needed: _ _OZo r..{ - - - <br /> 6. PREVIOUS OPERATION HISTORY: i <br /> - ✓ur <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: ko" a 4 0 NO rjo,%J <br />