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; r5 <br /> 1. SEWAGE: /Y <br /> - <br /> Distance to Public Sewers: ------ Connection necessary: Yes No <br /> Does existing septic system comply with San Joaquin County Development Title #549 ? <br /> Yes No Unknown If no, explain: <br /> Deccnt,P �PPr:� ���tatioaxo�e.,installed: <br /> 2. WATER SUPPLY: N J / <br /> Is water supplied by private well: Yes V No Is well proper: Yes L,�' 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 L/- ' way /well !� <br /> sampling current: yes No Additional information or comments: <br /> 01 <br /> � f � <br /> 3. GARBAGE & REFUSE: 'f u M i?.L- 7 well <br /> � <br /> Licensed scavenger pick-up: Yes No av,VIM M�a No.: Other proposed <br /> disposal method: <br /> Potential problem(s):J <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: <br /> 5. TOILETBATH FACILITIES: Additional <br /> Number and locations existing: <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> ✓2 Z �oF 4 <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: —� <br /> Approximate number of people per square mile: <br /> ev <br />