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,,,,. Marion County Date: 12/6/2022 <br /> OREGON <br /> PUBLIC WORKS <br /> Marion County Onsite Wastewater <br /> Site Review <br /> Tax Lot# <br /> Address 13039 Bethlehem Rd NE Gervais <br /> 051 W30ACO2200 <br /> Activity <br /> Major Repair <br /> 0.81 <br /> Parcel Size Acres <br /> Number 555- 22-01089 <br /> Completed by Robert Goodwin, REHS <br /> An evaluation of the test holes dug for soil analysis was conducted on 12/5/2022 <br /> The conditions observed during this site evaluation indicate that the area around the evaluated test <br /> holes IS NOT capable of supporting a standard septic system. <br /> Under these conditions a Capping Fill <br /> system is required by Department of Environmental Quality (DEQ) rules. <br /> **Please refer to the attached soil notes form and onsite septic inspection map(s) for the location of the <br /> approved area and the minimum requirements for the proposed system.** <br /> This site approval is for a system design to serve a Single Family Dwelling <br /> The maximum daily flow into the system is 300 gallons per day. <br /> The following documents are required to issue this permit (this checklist is for your own record keeping): <br /> n Plot Plan Capping Fill Detail <br /> Materials List <br /> Product Specifications <br /> System Stakeout <br /> • <br /> See attached guide(s) for capping fill Installation <br /> **See Reverse for Notes or Special Conditions** <br />