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Compliance Inspection Compliance Inspection Permit # 26326, UID # 9153
App. Status: System Replaced

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	Sheila Dahl - 02/11/2020 11:40 AM - witnessed by Sheila Dahl 83fd2b747667da02280e2d77212f83b0 a598554c4c1fb9a7484f8112bcdd0a5f
#1 Compliance Inspection Accepted	Sheila Dahl - 02/11/2020 11:40 AM 79577748527327aa76211dc41e19f476 f57b919e4d7b49b123027fec95b9fe2d

Inspection has been approved. All signatures have been obtained.