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(2) <br /> 1. SEWAGE <br /> Distance to i'ublic Sewers Connection necessary: Yes _ No <br /> Does existing septic system�y with Ord. aI;49: Yes _ No _ Unknown _ <br /> If iso, 4xplain:­'_' <br /> Describe septic installation to be installed: <br /> Additional information or comments: <br /> 2. WATER SUPFLY <br /> I* water supplied by private well: Yes NO Is well proper: Yes No <br /> S,tA.te deficiency: <br /> Does existing or proposed use make this well public water: Yes No <br /> Sample of well water taken: Yes No Date Taken Results <br /> Additional information or comments: <br /> 3. GARBAGE & REFUSE <br /> Licensed scavenger pick-up: Yes _ No _ Service Area No. <br /> Other proposed disposal method : <br /> Fotential problem: <br /> 4. FLY; MOSQUITO OR VECTOR 10TENTIAL <br /> State possible vector potential & necessary control: <br /> S. AIR POLLUTION POTEIITIAL , <br /> State possible burning or processing pollutants & necessary control: <br /> 6. MILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. t'kr.VIOUS OI'c.nA'I'IOIJ IiIS'rila <br /> b. GENERAL SANITATION <br /> State any problems not previously no,,J : <br /> 9. POPULATION Dr;NSITY <br /> Appx. No. people per sq. mi. <br />