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1• SEWAGE: - Connection necessary: Yes No <br /> Distance to Public Sewers: /�� <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: ro is well er: Yes No <br /> is water supplied by private well: Yes No p p <br /> State deficiency: <br /> Is well system a Public Water system? Yes No�-' Is the permit current? Yes-No- <br /> Does <br /> esNoDoes existing or proposed use make this well Public Water: Yes No <br /> Is waterlwell <br /> sampling current: yes No Additional information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes F�No- Service Area No.: Other proposed <br /> disposal method: <br /> Potential problem(s): <br /> 4. FLY MOS UITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: mz� <br /> 5. TOILET/BATH FACILITIES: Additional <br /> Number and locations existing: <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />