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SEWAGE `7 <br /> Distance to Public Sewers Connection necessary: Yes No_ <br /> Does existing septic system comply with Ord . 31549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic installation to be installed: <br /> Z . MATER SUPPLY <br /> Is water supplied by private well : Yes No Is well proper: <br /> Yes No-.X— State deficiency : <br /> (kfj; L4J <br /> Does existing or porposed use make this well public water: Yes <br /> No _ <br /> ulSample of well water taken : Yes No Date taken <br /> Rests Additional information or comments <br /> 3 . GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes No Service Area No . <br /> Other proposed disposal method: <br /> Potential problem: <br /> 4 . FLYL M SQUTT0 OR VEQTOR P'rraLTrALL <br /> State possible vector potentiftl & necessary control : <br /> , t <br /> 5 . TQ1LET/BATH FACTLITES <br /> No . & location existing: Additional <br /> facilities needed <br /> 6 . PREVTOQ2 OPERATION HISTORY <br /> 7 . Ems'NERAL SAiITTa�.'ION <br /> State any problem: not previously noted: <br /> L �I�� � red' �, U Y s <br /> 8 . POPI , TTn14 DENSITY <br /> Appx . No . People per oq . mi . <br />