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- MARtON'COUNTY&HLTh NC INSPECTION• - INDiVIDUAL'ON SITE SEWAGE SYSTEM ItECO <br /> 5155 Stivertan Rd NE (to be•completed by system installer) <br /> -°-- z SALEM OR 97305 . ' • - r� <br /> MARIOAI 5�3 58$;5147 PERMIT NQ .. °- • �? t� C�� <br /> t:0UNlttr htf '•t/www.co merlon orus1PV iBntiditt lns eetion <br /> v AeA .: 4 U f tEADRE , , . ( ( 47v< S : „c <br /> AS,;BUILT`PLAN;O1+CONSTRUCTED,SYSTEM, : • • • ;. <br /> Scale 1"- CI - <br /> tlt • ; to • ' N� i . arth," # <br /> �StC. <br /> ti P. <br /> ' <br /> 6. Z1 �e <br /> , <br /> {show all,details and-dimensions necessary to locate a(i components of the system in"the futur ) <br /> 5VSTE\1 MATERIALS AND SPECIFICATIONS: lNS1ALLERS CERf'7FICATION <br /> _ EIis M <br /> Svatem Design Sewage Powl SC} GalionsiDay ,, : STAtLtiir T THE ABOVE ADDRE S,WAS CO4 1 C'I'ED IN ACCUP. <br /> TANK size_ /e C t7 Mai;•gailons : (t9 mingle con parnm nt, DANCE NITH TIlE REQUIREMENTS OF.TIC PERMIT AND THE RULES <br /> OF'£HEENYIRO'P 11 NTALQL d iTX COIdiMISSIQIt <br /> Manufacturer �:1!G.1I.5( =: I };Bauble compartmenC ... _ <br /> ( i flow through I'I I.have,tested the septic tank and certify it to be.watertight <br /> MatenaL ' cC'st�iC£•c-fit_ = <br /> Effluent Sewer- The:s stem rites mstailedb <br /> �t` ilelder Pipe 1' 3 y y <br /> • <br /> SizeJ11'],at l _J - Size'Mst 1 �t3. { 1,Property Swner(PD ttee);..- <br /> 0:Ltcensed ewage: tspcsaI' ervlce <br /> DRAINFIELD rock depth(inches), Rolfes) ; _ . <br /> S <br /> Mick and ":: under pipe (;)Drop l I:Concrete . Q L . , <br /> D tcense.Number', � ('C`7 <br /> Pipe '' total depth '- l"l Distribution 1. Plastic •eittficattanNutnber. .�1(� <br /> Druiafield Maierial(Aitematrve orper!pipe)"' . <br /> DEQ E <br /> - .. . <br /> TOfat Drafnneid Fantagz Trerieh Depttt3vltnitnuttv� --, Mvcintum - <br /> Curfatn Drain Depth Signed <br /> Lt)Intnt Pump Pump Mc-dtl <br /> -Pui.ip•tycie,;. ... <br /> hides in minutes an' .:off Gallons per-Cycle 'Company[lame,. .- ( Y.I d+•+_ ''"�— <br /> (please print) <br /> ATT Make and Model:' _ .' <br /> .3' <br /> Attach'aii'nd'dltlonal sheet forcomponenb:and materials nnt'ILe'ted above. ;? ,,,:.. Tate, c.. h4 ZZ! " . _. -' • 3 <br /> i Fnr Marion Court'ty Use'Oniv i 'The above septic system has-been inspected by Marion County The information has been defer tined to`.:b • <br /> curate <br /> and the system is Approved [ i Approved with corrections:see inspection report [ j Dented . / j, G_ <br /> k, <br /> "` .1 I) -�Q�� � Date• <br /> MC 5-41 3 4(12;`;5/14 11/17 G\Forim\Sep4c\S-4I As Buitt2415Versioii2p17 doe 'WHITE Marion Gounty-.:YELLOW.•thmer.''PINK1!1:1 er. l <br />