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00 <br /> I. SEWAGE: . ` - <br /> Distance to Public Sewers: 44" C7 ,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 /> Describe septic installation to be installed: <br /> 2. WATER SUPPLY: '1 r? 7 0 <br /> Is water supplied by private well: Yes ----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 /> j r <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes No 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: <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HI TORY: f <br /> > t ' - X <br /> �1. <br /> J <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: " <br /> Approximate number of people per square mile: <br /> 3 <br />