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YLVl rL-An <br /> (gRtw TO srnt,E) <br /> SCALP ." TO <br /> 1. Namara of street@ or rondo nearest to or bounding the property. <br /> 2. Outline of the property, giving dimensions and North direction. <br /> 3. pimanyionad outlines and locations of all existing and Proposed atructuvus. <br /> including <br /> covered areas ouch as patios, driveways and wulks. <br /> 4. Location of house sower outlet, public sower, sewage+ disposal system or proposed savage <br /> disposj4l system, proposed expansion of sewage d,spusal system, or uny other possible <br /> source of contamiroAtion. ra ert . <br /> 5. Location of ocher wells within rad ius of 75 Peat porpwithin erty raaruJiuunufP100 feet. <br /> 6. Location of sewage dimpowal sywtum on adjoining property <br /> . . ......t... <br /> 3G1C)IL ' <br /> I �-- <br /> F I � <br /> j <br /> FEB 3 1978 <br /> SAN JOAQIJIN LOCAL <br /> HEALTH DISrmcr <br />