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sBSEPTIC 503-393-1311 .541-924-0851 <br /> SERVICE FAX 541-917-1861 •DEQ#38137 <br /> Date a 9 f V 20 -t <br /> Name LAVE ? l tJ E . C®tzNETL S <br /> ET.T I C <br /> Address 11L 1 5 S N\L 5T S E, S V I L L ,OR r G-13P G <br /> At' 6)r) 64. Ov..1 <br /> X ATI!, <br /> white-customer • yellow-office • pink-County <br /> • <br /> "/ <br />