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Compliance Inspection Compliance Inspection UID # 18457
App. Status: Compliance Inspection Accepted

Terms

Certification

By submitting this form I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of the future system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, inadequate maintenance, or future water usage

Approvals

Approval	Signature
Applicant	Ross W. Seifert - 05/28/2021 8:00 AM 7106fcdb6566c52b9140b76901ae870c 5585ea7ac96e6d30a4a2e7477790ff6b
#1 Compliance Inspection Accepted	Michelle Jevne - 06/10/2021 10:21 AM 9f583884e4e78953b14535b0e3147ab7 4058b68ab222de7217b28d2895d2f1b6

Inspection has been approved. All signatures have been obtained.