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410 <br />• <br />Department of <br />: F1C7RtUA_ tion <br />Environmental Protec <br />Central District <br />3349 Maguire Boulevard, Suite 232 Virginia ory <br />Governor real <br />Lawton Chiles Secretary <br />Orlando, Florida 32803.3767 <br />ENVfR01iViE NTAL RESOURCE PERMIT <br />INSPECTION CERTIFICATION <br />I <br />C'jnser.q cod Matioge Florrda's Envmwinwnt and Natural Ro oureas'° <br />Pnntrd on reevefed pope, <br />Permit Number: - <br />{e+i <br />` . <br />Project Name: <br />Inspection Date(s): <br />Inspection Results: (check onc) <br />I nearby certify that I or my desigd.ee under city direct supervision have inspected tte system at CC:C-Ove <br />with thm requsrc nerts of ice p:rrnit and <br />referenced proi[Lt orad that the system appears to be furctioninrgn accordance <br />F.S. <br />Chapter 373 (as aPplicaule). <br />The feiio'. ring necessary rnattltc=ce was cord=ed: <br />I hearby certify that I or my desigve. tinder my direct supervs;on hs taspected the system at er atovc <br />with the rC CL1e :l:ofS 6f the <br />rCferC'1c-'� proJ.[LS and that the system dots not appear to be f utcuo [t7rt$ in accordance <br />373 F.S. (as applicable). I have Wonned the operation and malntCnmc' eatiry c: rite following: <br />permit sd Chapter <br />(a) that ti'e s stem demi not appear to be fure,ioning properly, (b) that maintenance is required to h -g tktc system into <br />, <br />Lompla Le, and (c} if maintenance measures are not adtgoate to bring the system intoro �Plianc r System may <br />to Department aPP <br />have W be replaced Or an aitcmative dcsip comtrLLc:ed subsequent <br />Si$tvsture of ProiessiouJ Engineer <br />Mame (please print) <br />Florida Registration Number <br />company Name <br />Company Address pate <br />City, Sante, Zip Code <br />Thep---. \umber (Affix Seal) <br />Within =.6 drys o: ca-:p;e::vn a: &e "Apcctian. submit two copics of this fur'to tke fallat•iM 04_1: -"t Of"'"; <br />❑E?ART.,IENT OF EWVIROMIENTAL PROTECTION <br />CENTR.At- E)ISTRRICT SuSNIERGED LkNDS AND <br />E.lVJRO I.AENTAL HESCURCES PROGRAM <br />1,319 MAGU RE BLVD STR 232 <br />ORLANDO FL 3ZS03 <br />I <br />C'jnser.q cod Matioge Florrda's Envmwinwnt and Natural Ro oureas'° <br />Pnntrd on reevefed pope, <br />