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x. SEMAGE <br /> Distance to Public Sewers Connection necessary: iYes No <br /> Does existing septic system comply with Ord. #549• Yes. ' No Unkno_wn <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 _ No Is well properi ' Yes No <br /> State 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 /> Potential problem: <br /> li. FLY, MOSQUITO OR VECTOR POTCNTIAL <br /> State possible vector potential & necessary control: <br /> S. AIR PO LLU TION PO MMAL <br /> State possible burning or processing pollutants & necessary control: <br /> 6. MILET/BATH FACILITIES <br /> No. & location existing: Additional facilities needed <br /> 7. PREVIOUS OPERATION HISTORY , <br /> d. GENERAL SANITATIOIJ <br /> State any problems not previously noted: <br /> 9. FOPULATIO14 DENSITY <br /> Appx. No. People per sq. mi. <br /> i <br />