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1. SEWAGE <br /> Distance to Public Sewers <br /> Does existingseptic Connection nocessary: iYos No _ <br /> P system comply with Ord. Nj49: Yes• ._ No Unknown <br /> `. <br /> If no, explain: <br /> Describe septic installation to be installed: <br /> Additional information or comments: <br /> 2. WATER SUPPLY ' <br /> Is water supplied by private well: Yes <br /> State deficiency: NO ---- Is well proper: Yes No +M <br /> Does existing or proposed use make this well public water: Yes <br /> Sample of well water taken: Yes No <br /> No Date Taken Results <br /> Additional information or comments: <br /> 3. GARDAGE & REFUSE -- <br /> Licensed scavenger pick-up: Yes <br /> Other proposed disposalNO -- $OCe Area No. <br /> method: <br /> Potential problem: <br /> 1�. FLY MOS Uim OR VECIUR POIMTTAL <br /> State possible vector potential & necessary control: <br /> s• AIR POLLUTION POTENTIAL <br /> State possible burning or processing pollutants & necessary control: <br /> 6• 7nILET/BATii FACILITIl S <br /> tvo. & location existing: <br /> 7. PREAdditional facilities needed <br /> VIOUS OPERATION IIISMRY , <br /> d• GENERAL SANITATION ' <br /> State any problems not previously noted: <br /> 9. POPULATION DENSITY <br /> Appx. "40. People per sq. mi. <br />