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[li C E [IV EsTh7 <br /> �,, Marion County Public Works <br /> oil ',iii„,,� . • Building Inspection Division ,� <br /> a 1122f�1 <br /> 5155 Silverton Rd NE U� <br /> =��i/`�N Salem OR 97305 <br /> iii'" n � ': tT (503)588-5147 Fax(503)588-7948 MARION COUNTY <br /> http://wwwlco.marion.or.us BUILDING INSPECTION <br /> o s . <br /> ON-SITE SYSTEM MATERIAL LIST • <br /> (DIRECTIONS&DEFINIITIOafi <br /> NS ON BACK) <br /> .2? <br /> // g U 14-wS 1)a Il/ 6 TAX LOT# <br /> ADDRESS G� 6 SECTION TOWNSHIP RANGE LOT <br /> '1. SEPTIC TANKS <br /> • ,g. SEPTIC TANK: MFG. . • CAPACITY, MATERIAL <br /> 0 DOSING TANK:MFG. CAPACITY MATERIAL <br /> SEPTIC/DOSING TANK: 0 SINGLE COMPARTMENT TWO COMPARTMENT 0 FLOW-THROUGH <br /> MFG. O.1/a%f.."-1 S CAPACITY /✓k'v MATERIAL Cow c-- <br /> MFG:S SPECS.INCLUDED <br /> 2. PUMPING ASSEMBLIES ' •D . <br /> PUMP 1: MFG. / MODEL r --3c (INCLUDE PERFORMANCE CURVE) <br /> PUMP 2:.MFG. MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> CONTROL PANEL: MFG. as I MODEL S / 0 <br /> HYDROSPLITTER: MFG. MODEL _ (INCLUDE ORIFICE CALCULATIONS) 0 <br /> EFFLUENT FILTER: MFG. MODEL 0 <br /> DISTRIBUTION VALVE:MFG. MODEL ❑ <br /> 3. EFFLUENT TRANSPORT PIPING <br /> O GRAVITY EFFLUENT SEWER: LENGTH DIAMETER MATERIAL FALL(IN INCHES) <br /> X PRESSURE PIPING: LENGTH 17.0 DIAMETER G'6d MATERIAL P rc_ .PSI 2 <br /> aer <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: 0 EQUAL 0 LOOP st,SERIAL 0 PRESSURIZED . <br /> TOTAL LINEAR FOOTAGE: ilS0 <br /> DRAIN MEDIA: 0 GRAVEL-LESS ABSORPTION METHOD 0 ROCK&PIPE 0 OTHER F2 7_P1 ow <br /> TOTAL DEPTH DEPTH BELOW PIPE _ieri vbe(/' / ,� <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SURFACE): MIN �Lf MAX (2 <br /> CAPPING FILL DEPTH(DEPTH OF CAP): ' <br /> SETBACKS FROM WELLS: SEPTIC TANK 97 SAND FILTER OR AT I UNIT DRAINFIELD 22o <br /> 5. DEWATERING SYSTEMS(IF REQUIRED) <br /> O CURTAIN DRAIN ❑ TILE DEWATERING <br /> TRENCH DEPTH: <br /> DRAIN MEDIA: 0 ROCK&PIPE 0 OTHER <br /> TOTAL DEPTH DEPTH BELOW PIPE 0 FILTER FABRIC <br /> PERFORATED PIPING: DIAMETER MATERIAL <br /> 5. ADVANCED TREATMENT UNITS STATE CERTIFIED <br /> Environmental Health Specialist <br /> O SAND FILTER 0 'RGF 0 ATT: TYPE 4r,. EH-8.10 . <br /> t:40,1-- <br /> 3:\FORMS\SEPTIC\FORMS\S-60 MATERIALS LIST.DOCX Rev 3/18 <br /> Robert Goodwin <br /> 1P3g121 <br />