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. L <br /> 1. SEWAGE: <br /> Distance to Public Sewers: /N �raov i Connection necessary: Yes�� No <br /> Does existing septic system comply with San Joaquin County Development . Title #549 ? <br /> Yes No Unknown If no, explain: Wft 4o <br /> Describe septic installation to be installed: <br /> k <br /> 2. WATER SUPPLY: <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: i <br /> w <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes No Service Area No.: Other proposed <br /> disposal method: i <br /> Potential problem(s): <br /> 4 <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: = w <br /> State possible vector potential and necessary control: �ys� <br /> 5. TOILET/BATH FACILITIES: <br /> Number and locations existing: �- Additional <br /> facilities needed: <br /> b. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: ' <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: �u2 � <br /> Approximate number of people per square mile: <br />