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_ <br /> �Y— ln-coItt . <br /> t'1@C�tUlt � r_1 1 <br /> . lie�t�S hetectc�r 11:tttu ;'acl:urer : <br /> �� I1�T 61ow Flow , <br /> [ ] 1W' t311ut U � <br /> Status Q Arrival : . <br /> Corrective Actio11 : [� rfo <br /> Pt_ ed [ ) Ln <br /> ott-operatioal <br /> Status 0 Departure : [ ] errorured [ ) Required <br /> [ Uperat'.io11al [ ) lion-operational <br /> L <br /> Qas to o ] Tally, Uotti tozili t E! , <br /> -� y <br /> TYPE <br /> [ ] Visually Holtitored ( vally <br /> Site Well 1ltveltt_or}� ) <br /> [ ] Vapor Probes <br /> }> 111terstitial t-loltiL-or <br /> [A Flet [ ] D r y <br /> faltuCacL-urer : <br /> [ ] Leakalertr Cu) 11i'1�,�6e5 L53 [ ] Utller <br /> [ ] Pollualert (�) UC reser-Voir <br /> od e l : X705 <br /> Status Arrival : � oE,eratiolial <br /> Corrective Action: , [ ) 11011-operational <br /> Status Q Departure : [ ] Ferrii [ ] Required <br /> [ ] vP�ration al [ ] 11011-operatiottal <br /> = do certirY that the above i11t0rni�, tio11 tstld ol�eratillq status is <br /> representative of the actual co11diti011 Of the ttiottitoriny system. <br /> S i 11 a <br /> y <br /> fitf R RuF,-IJ <br /> �iT- <br /> compally <br /> 5aLe <br />