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Z6-COO-73ts in)C -1 <br /> tin of Oregon 0upertme nt of Env wmran*t sadly <br /> Annual Operation and Maintenance <br /> DEQ Report Form <br /> General thitenwitSon(taaptete ALL)ntormdbn) <br /> PNpos omen JJ&Konya Hoorn Prather 501.999-0953 <br /> sts*idiot 13823 Hebert Rd Patel s; 061W2BR 02600 <br /> 5`tYettOfi coYr Marlon Cagey <br /> Pamgs: 555-21012311-PRMT Slott update t1st year inuser 512023 <br /> System Mcnttdlt Ax2ORT soar sertel s: ORD522382.6 <br /> ttepatYear. 2°25 Oaths seam hstscissi 1:1411:12/2025 <br /> Email Address: naangMt82®prrllaciOm <br /> °netts wart watertreabnent system status: (Do not P►efltl and Photocopy checkboaes► <br /> Vse NO <br /> @ - ❑--Wes teetetwureo pni0arwd n abutted by epee**ern antes and the manutaflverl <br /> gMy 0 te aces system operWra in accordance th ardance we aged-approved design epetacenms? <br /> 1p, ❑ laths system currently under Lanka contract with a_aSd m*RMrhence prov(der? <br /> ❑ 0 Is me system tangy <br /> ❑ El Discharge 0t errata to the ground solace? <br /> r. Oledarae of aawaye to Math**or surface welaaT <br /> ❑ t3 sewage batlmp iota plumbing enures? <br /> If you memered"Yee on the ran four queens*.was a repair pama chiseled? If me,naryblrt <br /> I Writ that Ills Mart istmWleband accurate to till best of my knmrdedpe.ltadasund that bidergagon of PM <br /> report is proundslor manor%et msaMNanon inciter SA peneryers <br /> 'Maintenance tomtit mama(Muse mi t Bennet Septic Servk*LLC(Amber Bennett) <br /> 'Caddlaacns: RM245 _ 'Ca*ttanan Rainbow 03f3012027 <br /> Marco cny a,be owineplgtmpled) <br /> 01101riel Wen — o.t tZ-e. - <br /> Mew Maintenance providers must matt*cos a*records of IMt mainpronoe amen,salsners <br /> performance data,iS Wrieenee lotrenewing the contract& That records newt be anMMla fortnsperaon Upon <br /> request by the egg per OAR 34O-orr-one4). <br /> DEC Am.W Opwam an!IAateiaae Rapm Form Paw.410322 <br />