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Compliance Inspection Compliance Inspection UID # 19099
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 - 06/21/2021 4:47 PM 68d02b6f75a239a07bd48365c5c15de8 793293338af3c1971d0b098a3b462037
#1 Compliance Inspection Accepted	Michelle Jevne - 06/22/2021 8:21 AM a8eed879034724a3a9dd46961fed0ebc 121b5db953eb2cd98df852d710aa95d0

Inspection has been approved. All signatures have been obtained.