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Ir{L Iter !Y {Illfr 51' 1*UPru:km)A AU. '.,a -:+.�. HudrAL01lf.' '+r. t, :,G, ,7 t.X� J r.r U I 'IUs
<br /> J a� �(}^�71f YVti'7:"f,�/ r'rid 3i d pFIIY9 Ht, I ,. r ({ ,.P}tY'riel WI !li 17 fU� t
<br /> rl
<br /> �- t&f"G l�f(htl�l t:r iJLf!7. !f3Ne F•} I"'b r�;�k'n ,/�.:,��.j(�� I ... r..itl i1J 13�ILk Y� '1( .;.. s�',F r1 • �� P 2..rE !:I L.. 11-tY.,17Gi.Cil
<br /> d,M .4diAnect6rPropi
<br /> 1, �JMIn:PU 11C It ompliak component#1 of5.._..., �.
<br /> op.JIV.044. {AtPC ou i I er•: N,_ r. '.nu 1'oW ib tiiiMi"HCn,.
<br /> Cpm I n lon meth"
<br /> Syste fdl�ch aNilthe ❑Yee, No Searched for surface otitl
<br /> rotan�sulrj POP 1 S Searched for seeping In yanilbadcup In home N�
<br /> dit 114i.46"dtq" rairill. ❑Yell ®NO�` � 4 ,..?,�. ppese v9 p9q,41... A l syMem(Q-boxes W
<br /> ❑ Homeowner testimo See Commw tft
<br /> or surface waters . �Y( pmnaMon)
<br /> og;i 4 Ar It r tl r ® Black soar ebwe sdi dispersal system 140
<br /> ceuse-sewage' intof' "4
<br /> ❑Yes No __._ _
<br /> tiiirellirlf' ll�fi'r`frttn)b r _ ._ ,:
<br /> System requires'emergetrcyr pumping
<br /> ,� ❑ Pterfotmed dye teal r,
<br /> the s fe►ir fs .. _-.._ . _- !� �-Unatrte iQ verify(S'+m Co►nrrrent�rpierFation)
<br /> tw�ilich and Salhbr,
<br /> (See Commenta ftlanatlon)
<br /> d li M1lc 1�6 P + 7
<br /> Flops ocr _ �,+ ,I J ''� Il sFls c�or Initiawop'ie
<br /> `I: _ _- 1i*1 of 6ferI ication method(i)c... ._ .
<br /> System consists of seepage pit. [:]Yes ❑No ~�=Probedtank(s)bottom
<br /> P1t- r _ am6d Ch i records.:
<br /> rn4eg 6Qtnsyb .. ;Yes IN No F�$r iied`f"ah16% ! 1)
<br /> 1h iba" Inenoe. �x�fl , Spiro n a 11 iio a �
<br /> ys ode
<br /> Rhin to I IMARIDJ
<br /> P
<br /> de ��tsx rreratPon
<br /> ,� ta4utsi + �lflerr} .if.
<br /> LdemurgAw
<br /> Or f: D *8W to
<br /> r; '4 )
<br /> _
<br /> all i 119- rifietho"hWilsted°(See 0 mraenw**wtion)
<br /> R1A er,►r� r? Urahle rfl (Soca Co nrrrantsl�dsp(tar;aGnR
<br /> )►lung t" t;ta.: ;ubfi't; ea" 4 ZFy Ot)4, [; ;Jthe� .. Al�riot listed(<;ea�strlmsntslExpianallot
<br /> 3. ®ther Com #ance CQn ns—Cvmp 4nee component#3 of 5
<br /> rtilEN� r' LIQ Sto Khrally JJow nd bid M l Intrnrnxfft_
<br /> p trEc. b Immediately and adversely knP"iR wkt h qtl );❑Yes' 0 No ❑Unkntnvn
<br /> an
<br /> /Mm reatrtn paW/c. tend
<br /> ��nttsib ai a �e* ago pit, a' Yea �_.I R. '
<br /> Systt
<br /> nor le"' .!�l13�pik
<br /> i;,. �`1; C- amir. jast ttcdi'A records
<br /> Seepage pts Mtleettn; bei t-aam►nt !''";ink'.dtegYlt�*orm(Agoc;h)
<br /> '":� alcwved rn P��ral rrn�lnanr�7 :a
<br /> _ } }bs,JVk Jld It�vei Meow aper Ing depth
<br /> ,e iW. U bfgroutxl waterft otheiO&WItIons asdefel"Oilp
<br /> )fXp ►,s�w ;le�t�nK(go1 �artaer . de et# ,,"•fes
<br /> chic ".�IB,;,�,C:a
<br /> �- ❑ y �11x1d711�AtiJ�'K��ilE7'Sttt}l3)
<br /> Any*Yes an.wl►e a 6lt'0ve t ► ic.0 the.
<br /> w6gem is Falffo9 fGj RT`atructGrin,i►4tt,Fs`: id: Ej '(her rr}c;. .Os arra 11st rd'(See Comments'F.So)snatosb i
<br /> ` I
<br /> �`cr:zrmentivDpiarEatto►+. . .._ �: •� :�,:,,9
<br />
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