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5l-SSP613 ZX <br /> I SEWAGE <br /> Distance to Public Sewers Connection necessary: Yes No <br /> Does existing septic system comply with Ord. #549: Yes No <br /> Describe septic installation to be installed: <br /> -- Y <br /> 2. WATER SUPPLY N J GPS <br /> Is water supplied by private well: Yes `—No — Is well proper: Yes No <br /> State deficiency: <br /> Does existing or proposed use make this well public water: Yes_ No_ Sample of well <br /> water taken: Yes No _Date taken Results <br /> Additional information or comments: �,A AZA d, 1,42,& 010144922 4 � ti�P <br /> � ff�� �� ,��'_ �� � srz eJ <br /> 3. GARBAGE & REFUSE (�CJCLi \ �Y04 <br /> @� <br /> Licensed scavenger pick-up: Yes Quo _ Service Area No. <br /> Other proposed disposal method: <br /> Potential problems: <br /> 4. FLY, MOSQUITO. OR VECTOR POTENTIAL <br /> State possible vector potential & necessary control: <br /> 5. TOILET/BATH FACILITIES <br /> No. & location existing: <br /> Additional facilities needed <br /> 6. PREVIOUS OPERATION HISTORY <br /> CA - -'e" c l <br /> 2.0 i <br /> 7. GENERAL SANITATION <br /> State any problems not previously noted: <br /> & POPULATION DENSITY <br /> Appx. number of people per square mile <br /> � v <br />