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4-A IzT <br /> 7-/e XTf a ,' <br /> 1. SEWAGE: ? <br /> Distance to Public Sewers: Y4' 4- Ot f ec , n ne e sary YesNo 5 �p <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: 6 e <br /> — '?, 64 4d+0C !d <br /> 2. WATER SUPPLY: <br /> t �l�ixr� <br /> Is water supplied by private well: Yes rn1No 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 ent. yes No Additional in rmation or comments: — ✓ ` 2 TOS <br /> e e- <br /> s <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 PERATION HISTORY: <br /> r <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br />