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1. SEWAGE: /UD j2 r� 177-"acj d <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 /> z. WATER SUPPLY: /1/() <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 proposed o <br /> r ro osed use make this <br /> well Public Water: Yes No Is water/well <br /> sampling current: yes No Additional information or comments: <br /> 4 �� <br /> 3. GARBAGE & REFUSE: /VoNc N 77 e�� " <br /> Licensed scavenger pick-up: Yes No Service Area No.: Other proposed <br /> disposal method: <br /> Potential problem(s): o� <br /> 4. FLY MOSQUITO OR VECTOR POTENTIAL: <br /> State possible vector potential and necessary control: <br /> 5. TOILETBATH FACILITIES: <br /> Number and locations existing: _ A/o)9 Gfle,7 Z± rl ^fIJ _ Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> r l/ <br /> 7. GENERAL SANITATION: <br /> State any problems not previously noted: <br /> i <br /> 8. POPULATION DENSITY: <br /> Approximate number of people per square mile: <br /> a <br />