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� r <br /> 1. SEWAGE: f e�i�l�7 Fdl� � ,r OwnerGss�� �. <br /> Distance to Public Sewers: /,gone.. Connection necessary: Yes No X <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: N6' ?`'" 'r �2'e� <br /> Is water supplied by private well: Yeses` 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 informm <br /> information or comments: <br /> 3. GARBAGE & REFUSE: <br /> Licensed scavenger pick-up: Yes `� No Service Area No.: Other proposed <br /> disposal method: <br /> Potential problem(s): __ ,r/��h--e- <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: <br /> 5. TOILET/BATH FACILITIES: <br /> Number and Iocations existing: Cbz -�i7� ��/� c�lq✓�� dam ,, Additional <br /> facilities needed: <br /> b. PREVIOUS OPERATION HISTORY: <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> S. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> 1 <br />