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1. SEWAGE- <br /> Distance to Public Sewers: Connection necessary: Yes Nom <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 installer <br /> 2. WATER SUPPLY: <br /> Is water supplied by private well: Yes No Is well proper: Yeses- 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 Nov Is water/well <br /> sampling current: yes No Additional information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes Noe% 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: r ^� <br /> 5. TOILET/BATH FACILITIES: <br /> Number and locations existing: Additional <br /> facilities needed: CGT' <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: /s'� ;• ,� �,F �, <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />