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b. SEWAGE / <br /> Distance to Public Sewers Connection necessary: Yes No_ <br /> Does existing septic system comply with Ord . #548 : Yes No_ <br /> Unknowns If no, explain: <br /> Describe septic installation to 'be installed: <br /> 2 . WATER SUPPLY <br /> Is water supplied by private well : Yes No Is well proper: <br /> Yes No Stat"efciency: il <br /> Does existing or porposea use make \tL's well public water: Yes <br /> No Sample of Well Water taken: Yee No Date taken <br /> Results Additional information or comments� <br /> . J, , <br /> 3 . URBAGE REUSE <br /> Licensed scavenger pick-up: Yes No Service Area No. <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 • n a <br /> State possible vector potential & necessary control: <br /> 5 . TOILET/BATH FACILITEa <br /> No. & location existing: --- - Additional <br /> Facilities needed <br /> 6 . EREVTQnS OPERA1103 HISTORX <br /> s <br /> 7 . GENERAT, SANTIATION <br /> Stets any problems not previously rioted: <br /> a . ROPTILATIQU J2 *tST� <br /> Appx. No . People per eq. mi. <br />