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SFWAGF -7 <br /> Distance to Public Sewers Connection necessary : Yes No—V <br /> Does existing septic system comply with Ord . #549 : Yes No_ <br /> Unknown If no, explain: <br /> Describe septic installation to be installed: <br /> -- <br /> 2 . WATER SUPPLY <br /> Is 'Tier supplied by private well : Yes ,.,Y— No Is well proper: <br /> Yee XX No State deficiency : <br /> od L IPM�� <br /> u <br /> Does existing or porposed use make this we'll public water: Yes <br /> NoY_ Sample of well water taken: Yes No Date taken <br /> Results 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 . =L MOSQUITO OR VZ,^TO PC'r1M- T A,'u <br /> State possible vector potentiftl & necessary control : <br /> 5 . TOILET/BATH FACILITES <br /> No . & location existing: — Additional <br /> facilities needed _ <br /> 6 . PREVIOl12 OPERATI014 HISTO r <br /> 7 . QENERAL SANTT,ATION <br /> State any problem: not previously noted: <br /> i <br /> 8 . PC)PUL ION DELL `'T v <br /> Appx. No . People per sq . r,i . <br /> k <br /> �G <br />