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ORANGE COUNTY HEALTH OE'r ART:`ZNT' <br /> WORK ORDER TOWNSHIP 16 <br /> TAX P%P <br /> ' aLOcc� <br /> LOT # <br /> VAi-E OF PRCFE'ir TY MINER: . <br /> PERSON R£CUESTI�iG TEST. <br /> If different. franc owner - authorized by owner: YES <br /> ADDRESS: �2 .4Fv " Z,�� �-1 -go <br /> TELEPI�QNE: <br /> DIRECTION%PROPVM OESC.RIPTICN �.� <br /> WORK REgUESTED: FEE PAM: <br /> PRELISLNIARY LOT E-VALUATIMN <br /> SOIL ANALYSIS <br /> 111PROVDiENT PERMIT 0SPECTICN <br /> Sal CERTIFICATION OF COMPLETION LNSPECTI N' <br /> PURPOSE OF REOUEST is to determine suitability for graund ab=rptinn sewage c s- <br /> - pawl system. <br /> SFECIFiCATION OF PROPOSED STRUCTURE: <br /> MINER OF AUTHORIZED AGECNT. <br /> This. signature indicates permission has been granted to enter property gar <br /> purposes authorized by this work order. ) <br /> CLASSIFICATION OF SOIL FACTORS (CIRCLE) : <br /> SLOPE P5 TEXTURE PS STRUCTUREPS OEPTH 405 REaiRICTI��c RI7�.. ?g <br /> ORA INAGE PS PEn;•tEA8SLY T YP: GCx>> <br /> SITE CLASSIFICATION' (CIRCLE) <br /> SUITABLE U'NSUITA6LE Exp i anation: <br /> L'F �:SL::VI'1�:F r5t <br /> St ,'.C�. ..�.�5� l -/ � y� •`� <br /> �iiw'�iT�ir�1 �r SANZ TARiAN <br /> i <br />