Laserfiche WebLink
MARION COUNTY BUILDING, INSPECTION <br /> gkii <br /> 5155 Silverton Rd NE <br /> INDIVIDUAL, ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> SALEM OR 97305 <br /> 503-938-51 47 PLZA'''.NO '5-cc— 2 1- oo51 <br /> MARION <br /> COUNTY , httprEwww.en.marian.or.its/PW/BuildingInspection sire ADDRESS: /Ch Li c eDA.I. V 5.,ike'reir,a , a <br /> cilf/ <br /> ts-BuILT PLAN OF CONSTRI'CTED SYSTENI: <br /> Scale: 1" ..---- ' t <br /> ('icrer-ii live_ 11 North <br /> 1' a <br /> 30 <br /> Oti r <br /> 3'os del <br /> / <br /> b'N <br /> , <br /> ....0 <br /> 00 ....„„ <br /> **13...._ <br /> .....--N -, <br /> I <br /> .4 3..... <br /> 1° fat • <br /> 1 <br /> 7°' <br /> k` <br /> V 1 <br /> 6{; ....‘ ...... .6E. <br /> ' I <br /> 1 ot„ <br /> r Z.g* °.' k/k• 0 <br /> .• lli <br /> 144' ^ (1 1 • <br /> c:42. 2 I 3 <br /> (show all details and dimensions necessary to locate all components of the system in the future) <br /> slisIF NI'.I ATER!AI,S AM)SPECIFICATIONS: INSTALLERS( ER)I PK AVION: 1 <br /> stem°oli t,too 37 i 11ERE13Y CERTIFY THAT THE ON-SITE SEWAGE SYSTEM IN- <br /> o selvagec ciiiiiiinsimiy <br /> STALLED AT ri IF ABOVE ADDRESS WAS CONSTRUCTED IN ACL OR- <br /> TANK'Size_PO 4-O 2 total gallons I 1 single compartment DANCE WI Fit THE REQUIREMENTS OF THE PERMIT AND THE RULES <br /> Manufacturer ,r4,44,44fitt I 1 double compartment OF DIE ENVIRONMEN1 AL QUALITY COMMISSION. <br /> Material I 1 floss-through 1 1 I have tested the septic tank and certify it to be watertight. <br /> _ <br /> , Tillurnt Sewrrh . Deader Pipe. 1 :7, "I he system was installed by: <br /> , sire/M:40 i /1‘,g_5_ ,. SurriMati kil t rA r 1V,, 1 1 Property Owner(permittee) <br /> 1 1 Licensed Sewage Disposal Service <br /> I <br /> DRAINFIELD rock depth unehryt MEM I <br /> Rock,ind under PIN I I Drop I I Concrete DEQ License Number: <br /> Pipe total depth D"rjhutuln Plastic 1)EQ Certification Number: <br /> Dramtield Material(Antirnatlyc or pert pipe I — <br /> Total Drsiorield rootage 315- ireoch Depth Mmirnum zy Maximum <br /> ' Curtain Drain Depth. Signed: _ '1. <br /> i Ithient Pump: Pump Model <br /> purnp cycle <br /> . tinny in minotey no off Gallons per C)cle Company <br /> (please print) <br /> t I stress and Model, <br /> p tzt,ch an additional theti for VIM <MCI*and material%not listed abose. Date: <br /> ,t-- <br /> it For Marion County Use Only) The above septic system has been inspected by Marion County. Flie information has been determined to be accurate <br /> ' and the system isi Approved with corrections: see inspection report I I Denied <br /> --- <br /> Si Title: — IA/ /0 e9.-- Date: <br /> 4, <br /> mc,5-4 I rev:3)0.3,4/12.3/14,11117 ri'I intris'NepW\N-1 I As.itnia0 t 5 VUSI01120i 7 tit) IMIE.Marion Commit': 1C-11:(IP Owners PAW:installer <br />