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Compliance Inspection Compliance Inspection UID # 9256
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	Andrea Perales - 02/25/2020 12:02 PM - witnessed by Andrea Perales 6cad6504a7dff24001042d3a3aa48753 36431e8a17e85b5a74719d0f0f979c7c
#1 Compliance Inspection Accepted	Andrea Perales - 02/25/2020 12:02 PM 87c5eab5dc8dc56d03ea538c1c58c5b4 ea8786472c2123fd5afa77a37c9a6e98

Inspection has been approved. All signatures have been obtained.