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10512279
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Last modified
7/14/2021 4:01:28 PM
Creation date
6/25/2021 11:25:33 AM
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Permits
Permit Address
11998 DUCK INN RD NE
Permit City
GERVAIS
Permit Number
555-20-007035-PRMT
Parcel Number
052W35B 01200
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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Septic Permit 555-20-007035-PRMT Page 2 of 2 <br /> � �xwt'e�'4ewrzw�'� at� '� � v t. w .-T� ; n � k'>ra+i x . <br /> Bata Certificate Issued.06/1572+721 ;, � s p � 'x" $i* x= <br /> c.e a . . �. ,rG .' �k a: a a ;'�w -, , r ° <br /> WOrktDes on NEW INST•*BDRMVhSF �E r� � N <br /> Yc.= i :.. ••t ‘11, K Z:/ ,� 2 • K .n, f �.€t; k•''' .) u- ; r`... a., ,. y�"� • <br /> ;� �. '€" yy ..V+ �a h%i Y ;t'�25Y �i �1iQ �f'' �. � va���• ,•s,ver <br /> �r �:,. +.: v ,]r ."_ yC i §,��4w '' fib• �,!.- <br /> Installation of this onsite wastewater treatment system has been determined to comply with the applicable requirements in <br /> Oregon Administrative Rules Chapter 340, Divisions 071 and 073 and the Conditions of Approval above. <br /> 1. In accordance with Oregon Revised Statute 454,665,this Certificate of Satisfactory Completion is issued as evidence of <br /> satisfactory completion of an onsite wastewater treatment system at the location identified above. <br /> 2. Issuance of this Certificate does not constitute a warranty or guarantee that this onsite wastewater treatment system will <br /> function indefinitely without failure.Conditions imposed as permit requirements continue for the life of the system. <br /> 3.The area of the initial and the identified replacement area must not be subjected to activity that is likely to adversely <br /> affect the soil or the functioning of the system.Such activities may include,but are not limited to,vehicular traffic, livestock, <br /> covering the area with asphalt or concrete,filling,cutting,or other soil modification activities. <br /> 4.This onsite wastewater treatment system that be connected to the facility referenced herein within 5 years of the <br /> issuance of this Certificate of Satisfactory Completion(CSC)or rules for authorization notices,alteration permits,or <br /> construction-installation permits as outlined in OAR 340-071-0160,340-071-0205,or 340-071-0210 apply,including <br /> payment of an additional fee. <br /> 5.This system must operate in compliance with OAR Chapter 340,Division 071 and must not create a public health hazard <br /> or pollute public waters. <br /> 6.Unless otherwise required by the agent,the system installer must backfill(cover)this system within 10 days after the <br /> issuance of this Certificate of Satisfactory Completion. <br /> FL _ :? # 4 •'¢ v� Vhtra �rfVYRt�,,�f�. Q <br /> System Inspection: Yes Operation of Law-7 Days Notice: No Pre-Cover Inspection Waived Per 340-071: No <br /> Comments: N/A <br /> gat 'NV ' s_ .a� a xa � ,� gsa Facti, <br /> _ % .t - Completed+Inspections k , <br /> Inspector Inspection Inspection Date Inspection Result <br /> Robert Goodwin 7020 Pre-cover 06/07/2021 Approved with Conditions <br /> Rob Goo•, in - Onsite astewater Specialist 2 <br /> CALL BEFORE YOU DIG—ITS THE LAW <br /> ATTENTION:Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.Those rules are set forth by Oregon Administration Rules.You may obtain copies <br /> of the rules by calling the center.(Note:The telephone number for the Oregon Utility Notification Center is 1-800-332-2344.) <br /> 6/15/21:3:31:10PM Page 2 of 2 ONS_OnsiteCSC_pr <br />
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