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Alternative Treatment Technology (AU) System <br /> Certification of Installation . • <br /> In Accordance with Oregon Administrative Rule 340-071-0345(10), the installer of an <br /> ATT System must provide written certification to the agent that the-ATT component was <br /> Installed in accordance with the manufacturer's instructins and this rule. . <br /> • <br /> I, L►sc-kke_ k•o. .es - 'ems u-e-s-:, of jv1-s p a - \"vc,- <br /> • ATT Installer's Name Business Name . .. ' <br /> • <br /> Do hereby certify that I installed the following All component(s) in accordance with the <br /> manufacturer's instructions and Oregon Administrative Rule Chapter 340, Divisions 071 <br /> • and 073 and that I am certified by the manufacturer(s)to do this work. . - <br /> G- /''1 �-� Eli ss -. /'�, c-s--e;1/4:0..�.-c.-S • . <br /> . ATT component Name&Model Number ATT Manufacturer. . <br /> • Add-on Component Name&Model Number Manufacturer - • <br /> • Add-on Component Name&Model Number . Manufacturer <br /> • <br /> . - These components(s) were installed at-the-following location: <br /> ti l 3 •\3c,,-j n r-- --k. 1,.,,- 5 a e----` . - <br />' Address or Road Location City - . <br /> • <br /> L- .e� • /vl C.A_a,s6 • <br /> S. S 5-- t1 - c-,0 St. -e,e1r' <br /> Property Owner .. • - Permit Number <br /> ?.;--; .' - <br /> • <br /> • Signature • . • - Date - <br /> • <br /> • Dregon Department of Environmental Quality ATT System Certification of Installation <br /> Water Quality Division • • Page 1 of 1 <br /> • <br /> . <br /> Septic• - <br /> MC S-S6 . <br />