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STATE OF OP,~GON <br />DEPAR'I'MENT OF ]gNVII~ON"M~NTAL ~UAL1TY <br /> <br />REPORT OF EVALUATION FOR ON]E LOT <br /> <br />For OHic~ U~ Only <br /> <br />The Entire Property ~ <br /> Been Evaluated <br /> [~' Has Not .......... <br /> <br />PLOT PLAN OF APPROVABLE AP~EA: <br /> <br />Any al~eratlon of the nature] conditions in the ~rea approved for the on-site system or replacement area may void this <br />apprOvaL <br />~2~is approval is given on the b~si$ fl~t ~e lot or pa~l ds~ a~ve will not ~ fu~er <br />that conditio~ on subject or adJa~nt p~ies ~ve not ~n al~ in any manner which would prohibit i~uan~ of a <br />~it in a~ance ~ O.R.S. 4~.~5 t~ugh 454,7~ ~d Admi~s~atlve Rules of ~e Enviro~en~l ~ality <br />Commi~ion. ~ such su~ivi~ion, p~o~ng or al~ratton m~ ~ thi~ <br /> <br />The sfte h~s been found suitable for installation of the following kinds of on-si~e ~ewage dispo~l ~'~tems, with the <br /> <br />WARNING: This doeur~ent is a technical re~rt for on-si~ ~w~e ~iz~l only. It may ~ ~nvert~ <br /> if, at the time of appli~tion, the pa~l ~ ~en found to ~ ~m~tible with appli~ble <br /> acknowledged 1~ ~mp~hens~ve land ~ pla~ ~d lmplementf~ mea~s or the S~tewlde Pla~ing <br /> ~a]s. ~e S~ment of ~m~tibfllty ~y ~ ~de on the ~t~ehed form or i~ equfva]ent. Au~oriz~ <br /> Agent app~v~l is ~quir~ ~fore a ~ion ~t ~n ~ i~ued. <br />~~ ~id~n.o~s~%~wage ~s~m is implied ~nt ~ a ~ction ~r~t ob~fned from <br />,-~~~, or until ~ller ~lla~on, p~nt ~ ~mmi~ion ~les, wi~ writ~n <br />thereof by t~pa~ment ~f ~i~n~l Q~lity ~ ~e ~e~ a~ ~ ~p~ment ~s or the ~unCy tax <br /> <br /> <br />