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1. SEWAGE: <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 /> 2. WATER SUPPLY: 4"' eff <br /> �p�„ � ! Cgs`2�0"7 <br /> Is water supplied by private well: Yes No rss well roper: Yes No <br /> S,Wle-deficiency: - <br /> 2 �s ztc <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: <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: S d !�� tom. Ij <br /> 2- <br /> 5. <br /> 5. TOILETIBATH FACILITIES: <br /> Number and locations existing: Additional <br /> facilities needed: <br /> 6. PREVIOUS OPERATION HISTORY: <br /> // 1 _7. GENERAL SANITATION: Jlo <br /> State any problems not previously noted: 7Xa N-P <br /> 8. POPULATION DENSITY: �� W��`� Y y � ✓�� ae�'a <br /> Approximate number of peo 1p per square mile: 7�1 ':� Al <br /> 00 <br />