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Q , <br /> I• SE� w�' Connection necessary:, Yes No`s <br /> Title #549 ? <br /> Sewers: Ti <br /> Public Se ? -��{?— Development . <br /> Distance to Pub •-� <br /> Does existing septic system comply with San Joaquin County Develop <br /> Yes—. No Unknown--If no, explain: <br /> Describe septic installation to be installed: <br /> k / <br /> 2, WATER SUPPLY: No Is well proper: Yes No— <br /> Is water supplied by private well: Yes— <br /> State deficiency: <br /> Is the ermit current? Yes No <br /> ' Is well system a Public Water system? Yes No p Is waterlwell <br /> Does existing or proposed use make this well <br /> Additional information or comments: <br /> r: Yes No— <br /> sampling current: yes No <br /> 3, GARBAGE & REFUSE: / Service Area No.: <br /> Other proposed <br /> Licensed scavenger pick-up: Yes 1`�o <br /> disposal method: <br /> Potential problem(s): <br /> 4, FLY MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: <br /> 5, TOILETIBATH FACILITIES: Additional <br /> Number and locations existing: <br /> facilities needed: <br /> } 6. PREVIOUS OPERATION HISTORY: <br /> 7, GENERAL SANITATION: <br /> State any problems not previously noted: <br /> g, POPULATION DENSITY: ` <br /> Approximate number of people per square mile: <br />