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(2) <br /> i. SEWAGE <br /> Distance to Pubiic Sewers Connection necessary: Yes Ivo _ <br /> Does existing septic system comply with Ord . #549: Yes Unknown <br /> If no, explain: <br /> Describe septic installation to be installed: h -� <br /> Additional information or comments: <br /> 2. WATER SUPPLY <br /> Is water supplied by pri.va e well: Yes _ No Is well p opera Yes 10 _ <br /> State deficiency: d— <br /> Dots existing or pro osed use make this well public wa r: s <br /> Sample of well water taken: Yes 110 _ j�j e Taken <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes �_1No Service Area No. <br /> Other proposed disposal method : <br /> Potential problem: <br /> 4. FLY, MOSQUITO OR VECTOR POTENTIAL y <br /> State possible vector potential & necessary control: <br /> 5. AIR PO LLU TION PO TET4 TIAL <br /> State possible burning or processing pollutants & necessary control: <br /> 6. 0ILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY <br /> b. GENERAL SANITATION ' <br /> State tny problems not previousl noted: <br /> 9. I.OPULATION DENSITY x <br /> Appx. No. People per sq. mi. <br />