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� J <br /> �v <br /> 1. SEWAGE: _.1--- <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 /> e <br /> 2. WATER SUPPLY: ,1 ! J <br /> Is water supplied by private well: Yes No Is well proper: �. <br /> os�r F <br /> State..dePiciency: <br /> 40O*` Is wel systema u is ater system. es she permit c --ado <br /> Does existing or proposed use make this well Public Water: Yes No Is water/well <br /> �( t sampling current: yes No Additional information or comments: <br /> 3. GRBAGE & FUSE: <br /> Licensed scavenger pick-up: Yes__Z,,��o Service Area No.: Other proposed <br /> disposal method: _ <br /> Potential problem(s): <br /> 2_ 40_ •p <br /> 4. FLY, MOSOUITO OR VEC 6R POTENTIAL: <br /> State ossible vector potential and necessary control: <br /> 77 <br /> 5. TOILET/BATH FACILITIES: U <br /> Number and locations ting: 2 ,1 jber A44itiunal <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> / <br /> I Mor <br /> 7. GENERAL SANITATION: <br /> State any problems of previousl noted: i <br /> 1 /91 ' <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />