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<br /> Comments: �� 'F�LI�I� �OL�'�O'��wt t�, L11U1�- 'P�S�?wr�`F- l�� 3c� ot�tis .
<br /> Person Responsible for Monitoring: 5 L1��rii r-��S W�� t�J���--
<br /> Address: 9�1 1�DrC`�b t� �fl ��:
<br /> City/Zip Code: � . 1��1� �Za xl���� J'Y1 Yl SS:'� �
<br /> Telephone: � -- "� — lo� , .
<br /> Signature of Person Responsible for monitoring: %`�=-- . - � s^ ---
<br /> �
<br /> 3. Maintenance Requirements: (List any additional requirements for this system. Examples may
<br /> include Lffluent filter cleanir�g/replacement or pump and alarni components.)
<br /> .,... l. t ...;.;. �. .. .y. f;...;..... :'•>:: '�.ti/••� ,�i,::?•' .\.
<br /> • "W 'y �''+."'L'<'i`.�.•'+Y'., n..A i•,•�� •.. ;i#•.'ti`..:, .,,ti4f�....�,,fiv'.'+.
<br /> C " �3�'�• • •7'i`•:�"'' t•• k�.;;.\.,:;,'>+�•�/,�•'• •✓ . ` <.
<br /> � ;v}.:� `.•,. . : . , ` �' '�%';�"� 'k/.'' � • `:',sY'.f':���' >f i: l,';r,'i {i�`
<br /> � •�'� :}'.f�`..,£x`.,..: •� •ti�:. • ••!`���''�'�' �'S!. • '",'
<br /> Septage All septic tanks
<br /> RemovaUmeasurement
<br /> WH�� S�r'�'C`- ��--
<br /> 50�-�� A � O"7� � C,. ►�G- '- �C J�>'�F..,r ,
<br /> F�� v�n�1��� -'F�...0
<br /> Comments:
<br /> Person Responsible for Maintenance: S��l��w��s•�-e... �.0��,�� t.��1-���
<br /> Address: �t t �G/.��C�--�,o ,�o L t� ., �-��
<br /> City/Zip Code: �. Wl� U��A�L.., rY1 � . S.5'"Z rJ �
<br /> Telephone: 7 c�?. - `-I `3 �) ---? Sl�l,r , ,-:'
<br /> Signature of Person Responsible for Monitoring:_ L�:�,r�2� . �-�-----:__�
<br /> 4. Mitigation Plan: (List any additional component in boxes provided.)
<br /> :....,i. L . ..... .,::,:.,.. . .,. :... .:.,:::;.•..�::::�.,:.,... :��.::;:..::...., ... ��: ...:,�,�....
<br /> , A � . :•.;,.L,.: .�.. �:,y�,y,� �,. �j'�• ,.,+Y�•��,
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<br /> • �� ro?S' ���' :: fi/�..•r
<br /> • . ., .; 'r, . .
<br /> ., �'ri
<br /> • ' ' • '' ' '• • ' i
<br /> . . .. . .;; ..,. .. :
<br /> •�k"•� . `wS�:\`}�x�°.•�5..''+ ::t'' yi�' .`'�'
<br /> Pump/alarm �
<br /> M11 L..'�i - ��.-O ,�
<br /> �l r•;-tcnz. S-s� '? �- �o
<br /> �_�
<br /> r.-�
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