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, � 3:06 7634988290 F�2US'i-Y5 PERC TESTING PAGE ��. <br /> 01/2�/2012 1 <br /> , .: �- ,. _ __ <br /> _. . _ ._ _ <br /> Par��1 number. 03�117•23��-t�t110 _�,._ System staAus= �Compif�rrt ❑ Noncomplie�t <br /> o-. .— (aa detemuned by fhis form) , :, , , . , <br /> � , ,� . . k i�l,;I�C6,,� <br /> ��r�auli� �'sr�rrnanc+� �nd Other��npl�ae� �,� ,.:�, <br /> �r�r��lianz� Issu� #9 af�� ' ' <br /> C7ut�tr�obs+e�vetfan: 1/20/92 Reeson for obs�rv�tfon: Pro Tr�nsfe� _, _ _.___,.-_ <br /> '1`t�l�#'br�n expires upon ne�R inspaction or in three yeers,uvFtichever oCcur�fsrst: 1/2DI2015 �,._., .._.__ <br /> �i�:�91ar1r.�c������srJcritsr�' (�equired) ��rifiCiltiOn Method': (O�tional) _ <br /> __�Check the app�fe box) � •-- (Check the epProPriatv box) <br /> Ua�s��'�+�systern discharge sm���e to the ❑Yes � Wo � Sea�ched for surtace outi�t <br /> �rou.�cii�urfac�7 . <br /> . ❑ Perfnm►�hydreulic ta�,st <br /> �3�s�{i�sys�sem dfsche�ge st�uvsge to drain ❑lf� � �� <br /> tiil�ra��u�aoe w�ters? r _-w_...__ � Searched for seeping in yard <br /> Ct���e sys9err�ceu�e serwage bacicup ❑j'u.� �P10 I�1 Chedced ior badcup in hame <br /> _,.__ <br /> I�n��:w�lling or est9bt6shment? _ ,,�;I=" _ _ <br /> _��_� ,_ ❑ �Exoessive pondfng in soii system/D-bo�e's <br /> l7�c r�s��r situafions�xiat th�Y ha�ve the ❑�°�3$ ��n ❑ Homeawner tes�fmony <br /> pu4c�r��4al to immedi�tely�nd adv�rs�ly <br /> I�p�t or threaten ublic health or safety LL,. _ _ .__ ; , � �'�mined for surg�n j :` ' <br /> � g in tarz <br /> �n"ye�sp��,�r lrnil��syatom!s an�'r�a»Onern '' � S la em re uire�e�mfl di�pert3�l�`��stehi <br /> �t�. ncal,u s:�fe c.�ver� etc. 7 <br /> �D�^�2 a6o pecb!(�he�IPh arrd� ❑ 5/$ Q �t'per�c�'pumping <br /> „r.__.___.�_ M.... ----- .r ❑ Perfvmned dye t��t <br /> D�;��24p�'F�t�{n:RnEe,a:thr�at'tq:�rQ�+►�d ❑Y�P���:�:;P4Q.: �,- �:; [.1 Other. <br /> va'�:�f�r eny wndi��r►s deemerr9 no�- `— -- -- <br /> �s�riective,a�::deterrnir�cl_[�Yth��n oi? ..^_ �,....�, _. ..._ _.. <br /> ,•Y�.�.,'��ad�r.at�:t�s�t tlrs,�ysrarr►Is fslNn�tv prot�ct > Y ; °.°,� . �_....m._..._.----- <br /> g � ter fl� �•,,descrd�the conditian a�tod: . . . <br /> f�e�.a�a9� " ; y :, . , � .,a:: � . ; �Ado starrdeid prutocd ezists. 7'his.list/s rrot exh�ia:�li�a,. .. <br /> � <br /> �� ; . : <br /> —__ i�r srtquar�Bel ader, nor c�oes iP indicate which <br /> ;��,qr#�����M�� rg:��d.,.r��r,�r i;, b�u �� i-::: , .�_�_� �`��rrbfnaefons are n�c�s�ty,#u make this deterrr�;nati��i. <br /> �.,, ;.,,,��� - <br /> .. . � .. 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