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1. SEWAGE: <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 /> Describe septic installation to be installed: <br /> 5 7 3-0 E_ P IA4 76 - 7 7 3 <br /> 2. WATER SUPPLY: /064'*4 /eZ4' -r! 1` 9d Fr6 <br /> Is water supplied by private well: Yes No Is well proper: Yes 4--" No <br /> State deficiency: <br /> Is well system a Public Water system? Yes No U 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 comm ts: ��- <br /> 1 <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. PRE OUS OPERATIQN HISTORY: <br /> lCo <br /> GENERAL SANITATION: <br /> State any problems not previously noted: <br /> R. POPULATION DENSITY: —` <br /> Approximate number of people per square mile: <br />