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s ser a� # s� �ti�a s s� si�c�ud ali�nct��wnar res�y{artaib fir
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THIS INSPECTION IS VOID IF:
(1) the intended use of the septic system should change, and/or
(2) the system should fail or malfunction, and/or
(3) the owner or tenant of the property changes, and/or
(4) after six months
�JILDIN{ M` Be 5' FRf�N ANY PARS SEsFTI S1TEN
D I *DR11C aid P�RK O SEPTIC SYSTEM
AUTHORIZATION OF EXISTING SYSTEM
ako,,,412F
Si6&ture of Environmental Health Specialist Date