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1 <br /> 1. SEWAGE: qy2/-60 yo PeirA71,s <br /> Distance to Public Sewers: A <br /> Connection necessary: Yes No A <br /> Does existing septic system comply with Sari Joaquin County Development . Title #549 ? <br /> Yes No Unknown If no, explain: . <br /> Describe septic installation to be installed: <br /> 2. WATER SUPPLY: A) "t' q•zr•aa <br /> /UGW�arc.�(s <br /> Is water supplied by private well: Yes a'"e '�No�! _ Is well proper: Yes No <br /> State deficiency: <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 Service Area No.: Other proposed t <br /> disposal method: <br /> Potential problem(s): <br /> 4. FLY;MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: Norm <br /> 5. TOLETIBATH FACILITIES: <br /> Number and locations existing: ,iv Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> /All <br /> 7. GENERAL SANITATION: > <br /> State any problems not previously noted: �`o�li9nt <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />