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ORANGE COUNTY HEALTH DEPARTMENT 3. 35, _ <br /> • WASTEWATER SYSTEM INSTALLATION 1NSPECTiON REPORT <br /> nr[1T IQra�E t <br /> CAMP coe-5T NUT LOCATION IAA T CB.4-rN <br /> APPLiCANTIOWNER: N s�� <br /> SYSTEM INSTALLER: L au��E ReaRZ- DATE OF FIRST INSPECTION_10-10-77 <br /> TYPE OF SYSTEM: CONVENTIONAL m PUMP CONVENTIONAL ❑ PRESSURE MANIFOLD ❑ LPP C <br /> TANKS 51 MANU �5 i'I �U PUMP REQUIREMENTS <br /> PT GPM @ TDH <br /> STB- �45 BRAND <br /> lash GAL �— GAL <br /> PSI li <br /> PSl MODEL <br /> DATE S-r4 ALARM OKLEAK TESTE-Ed PULL ROPE RISER OK [ Q FLOATS SET ❑ <br /> Sll PLY PIPE SIZE, ELECTRICAL ENCLOSURE ❑ <br /> OK TO COVER ❑ CONDUIT, DUCT SEAL ❑ <br /> PRESSURE TEST ClGROUT ❑ <br /> COMMENTS <br /> PRA1NFIE1 D <br /> .� pip anal 'Jq. <br /> 9 N <br /> a <br /> r x ! f <br /> n <br /> DATE, YET TO DO: <br /> to-w•9] A= <br /> S. <br /> COMPLETION DATE ENVIRONMENTAL LTH SPECIALIST <br /> 164 <br />