|
Parcel i_r .,.r .5ystem ....., . .,� . - ..Noncoin�l�an,
<br /> {as rlc�trr..,.,;�,..,by,��.,,,:....,.,
<br /> T�rtk @n�e�ra*�,y �=��3 S�f�*ty��m�stiar�tc;e-Gr=rn--tr�,r�e lnspeCtia� �r.'��lor�Fxistiri� SS�S
<br /> Compfiance Issue#2 ef 4
<br /> Cateo r� ..�. 4.r,in _._ �� �Ra�,.. R�•.IF ,a!e ..-^aclion
<br /> . . .. '�nxF<'...,�n',.ma� _._.,.
<br /> Campiiarice questians;eriteria��Rr�q:,te�) Verification Method'"'{C�pt�onal}
<br /> (f't+ .._. � .._ .^rr} ,,^,�rek thp�Pprc .-�t Uox)
<br /> f?ae;�.tht 5 �_�._ . .-'of a e��.,a^.�nd'. [i�. , E;No ,.. :`'.:,t><tC 12nk boCto:t��
<br /> cessra-�,dryweu e i �,.�m�,pit?
<br /> {J O" -7�1 iow iiquid ievei
<br /> Uo.^� �!�e. '�y)�•..,s _�,�neir ❑Yes �No
<br /> ...i,..,r�! , ..ra,ir�g r•h� . l ......��ed '�..;;'.�- -er,�,ds
<br /> If v�=s �^r�ti!y��r";.;`. _�: FxaminEd et".r,7y(purnped}t3nk
<br /> , . !^unk ieaks ;.,_f 4'rr,beii outsid2 lank for`bla�k so=1'
<br /> ,..
<br /> Any"yr '� :�.,,r . �,'es t.,...,,� �to�n is fa•�i.�q to prof.ct
<br /> ;:�dwafer. t__i Pre,s::���"�acuumcheck
<br /> 1_i Otrer
<br /> • coo,a�e� . _ , __"roay be�cx3m� �r�,,.,��
<br /> ir.,^.rr,'^ „p��� _ ..i ... •:nc �,. .��n.ty.
<br /> .,;+lt'"'.r.:.-':r,�`,;rOt�D!2xiSlS. This f�c IS nOt Br.t.�.:^•.vC_ut
<br /> Stl'qt . ".... fr>� . �'r! .....r�,, ..,... ... ..
<br /> ;,rc ncr .. : c .^�Y,�s derc.,, __ ..
<br /> Safe"�C`���k
<br /> 1_ Are ma^t�.^,^,ce hoie^ ,•°ds;m , .d :v,t�>d cr-_:r.,.:,�,�h- r,�..;��v u^sound" ,� !es' No
<br /> Z. N ^��c�:�. : - � 'i�a cecured��i.r^er re� rr. .:�,d�� j. �es ���Np'
<br /> 3. N.+-cetr,^�. �a.�-s r[...�-.•nt p .sent(ss{e�y oac.sC-...�-,.ci rover,..r�a#cty^..tl.n9:- h�'.M7,-�:':r--_-^'.d. ��_Yes .�No
<br /> a_ Are o'��.�.. .lv�he^Ith , ...z^•o L,I Yes' _.'�c
<br /> Exp�.,..,
<br /> Sys?��^ss an;...-..,.^en!thrr,;r'io publie hcai.h and s�fcry•.
<br /> C'?i Cl�?C2.�:O�i
<br /> This`> t�:s tc t: . . 1e<i � � ,_�t1�;��to ttie o �:�� ..,:�i t�.M-, �ot:�Pc� .�cn Cc.^.i�ci Ag<��:�s�MPCl�)G>r;��,tiancc
<br /> �,, ,
<br /> !rsacchor.P�>rr, ., u...�st�rr;S�,ksstsrface Sewac�^TreatmanY Syster^; i)^� .-:�ions.mt =, �.'+iVons.and- I: �;^s must be
<br /> c�- :•^^by ar �-_•�. .,,; . ,rc�r . .-'.�;* •, r,e+r,ad• r.--.St be 5:`r•s2�ed te the ��^�uni�of goverrr-enE wdh�n
<br /> 'r y.- . . ... . ._ ..
<br /> f>renerty o�vrr�•..... .:-,.,>(5)- Faek Qwned
<br /> p��aa^rty a�:'..s-� 85 l.:cc'_�ne R�",�e
<br /> ntjy .._;. a_
<br /> County. `a,�..n�pin P.^r�^y,ov.�^ar ph�a^:
<br /> ;hr�r:' ._ �, ?ha� ' .... , .,; n:.i.,�•n.^�R^nr ..... .,.;:Sr�.•� ,^r^+ronctus�ons n���::;rted Jr thiS(omi ar�o tAat they are
<br /> N-,..� �had t-.._-�}.. G,°rt�..p�^afiPn numbec S5 '
<br /> Busi^ � ._-.. �� .,_... n� - :�r,. 3.ha•.�k 5,-..,<r SQ�ice or
<br /> _..��-�of locai-: 9^e•�� C;i?y oo(Oro�o
<br /> S�gnatu;e Da'.e �Ig170
<br /> �' .
<br /> J q
<br /> �Y. �•t+•��. , . � ��.... .' >cp,.a:pp • gp�.44'.33b4 . TTY 657-2$7.....:;ur$06.Gh?.}&&t <;'.=^.le in etL•r,.•,crvelormats
<br /> � ��rn,�;•.,t 'i • a!24i�J9 n.,r-3 cf 8
<br />
|