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r <br /> 3)1-t ,d,,,DLt-Tn-v- <br /> ...... <br /> ..,• <br /> , , ,,,,,. ,„:„...,,,,,.,,,,,..„:,,,,,,,,,,,,,,",:„..,,,,,,,:„„ ,,„,,,,,..,„,.„,. ''.k.,,''-Y:.'',5,5,..„lit.:,,,;:. 151'5„,',T,-,-„,', ','''',,•,, 2,..".•.b.,,T.,...';.!:" <br /> ;::::: 1 •„i g, ,,,-1 ,„ ,,,,,,,,,,,,,,cr-,ts.' '..7 4...., ... <br /> „MARION COUNTY PUBLIC WORKS ,q...At <br /> -5..,,5 <br /> BUILDING INSPECTION DIVISION <br /> 5155 Silvertna RdNE <br /> Salem OR 47305 <br /> 4, ,111111 .SO31588-5141' FAX(503)588-7948 <br /> , t haripahlic-norits,comarion.ar.usibuddingi <br /> fiterS SePti It, <br /> ,..,re,no41 ricgtrecq. <br /> 4.1'.1 ' • ' re v.,,,,. „, • <br /> ,w. . <br /> .. . <br /> SEPTIC TAiiK ABANDONMENT FORM 11:_ <br /> farme...,wt.,«.p.,p.i,„,,,, <br /> i,,,,;.• <br /> 30.3187344 <br /> ge.41#`4407 i <br /> — --INVOICE Ligli T ,2'4-4e,AJE <br /> , •;,. <br /> HE suric TANK.,1. <br /> •,, , ORE 7,, II€.;:' <br /> 11 ACTIVITY NUMBER: <br /> -,, <br /> i WAS PUMPD BY: r,::-.1.',,'ST 1,_4,,•er.._.'21--; _ <br /> ,,.., <br /> DEQ1.5iumse# !_`-l'j2L... ,rii: <br /> [WIT TANKRUMPED' <br /> , . <br /> '.DOSE DEStRIPTION AMOUNT , <br /> 51:',,,'O.O.,',1.. t j__ ; ENCLOSE A COPY t)F THE P1,".t1PING RECEIPT.WITH TOOLS F000MI <br /> .„..„.5 <br /> TANK WAS: <br /> qs ,- • .e::;'". <br /> •••-r---'-±'--- 5.4 REm()vr'll '',„9-., <br /> ,... • ,..,ee..e..-:ce ;,.,-1.;',,1T F._..l_• ! ,1 viLihn <br /> . .. <br /> ,,,..5, , , • .5 , 5 - ' %,„---;„5 --TITT-4—t <br /> (NOTE:'Me aAtil,Cif th,.-t,..A.7.5huldb..,periorg5.-.5:5cr.,-.Ied,oprohibil.die --,,"•..-!:::•-•,:T,....:5.55...5„,.. <br /> ,------'--5--. : .„„5_.T5,5T:,.-,... of stmt.we°:;p.tfi tatki 5 <br /> • <br /> ,':-,5 ,5 . ---1 FILL M,,,TERIAL <br /> :3 5 <br /> x <br /> 1 <br /> • . 1- ',. --e-----.e.,,,e'-e- e-..-.e..e.. 4\,:-.;.,..-----, I; REJECT iAlifl <br /> f 1 RAR RUN GRAVa , ' <br /> . . --t----c-t---1 t CRUSHED ROCK <br /> ------ <br /> , ,,i 1 , -,..•-, TT,-.1 ',,, .,SRINEJ; /51,„-grY\.: .' •''„ i HTT7 77: .-5----- ' . „ii---,:---4-----: , ,. ' ,•''.1''33 <br />. .., . ,, •..,•.!';! <br /> - r " '. 1$1,..",. • ' • ... <br /> ...,,,, <br /> ,;;..... . <br /> .:::, <br /> . . ' ''-j':.!...g,: ,•4:1,11..,1...,,,'-'''.°:-:,`,.':,.,.7:ii!,''''':....TO`!,'":,;:t5.7t:'""54;„:3„,p,plifi5,5.,Aa005 .;..!,,i,-,;,,,O,',5iirit.,,,,t'5, Ri:XN`,;54,,,,'„..fgr?4,,,'S,,,,, ,...,,irTrirmL„,, ,,ki ..;... <br /> ,,,,,,,,,,,:,,,,,,,:,,,,,,,;,,,i,,,,,,e-de,---,,,I••.-e,',,--.,e- ,-,- ,-,,,'•-, .•=1, • , -, ',e,',,- - - • ' ,;• -,, -1 '''- - ' .:1,•.41,,.,,,,..,„..,. . <br /> ::,,,.',,,”:-,.:,-. .--.: ..',.5:..;-61.4•'''''' <br />