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M�,. , Marion County Public Works <br /> ��I +�:' � Building Inspection Division <br /> 5155 Silverton Rd NE <br /> Salem OR 97305 <br /> (503)588-5147 Fax(503)588-7948 <br /> http://www/co.marion.or.us <br /> ON-SITE SYSTEM MATERIAL LIST <br /> (DIRECTIONS&DEFINITIONS ON BACK) <br /> ADDRESS- 70`3 1 s �c <cS,c v`U4c , CN TAX LOT# <br /> SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS <br /> SEPTIC TANK: MFG. 1.114, CAPAcrry_ 1/ 5OO - MATERIAL 6y in v.?i <br /> ❑ DOSING TANK:MFG. CAPACITY MATERIAL <br /> ❑ SEPTICIDOSING TANK: ❑ SINGLE COMPARTMENT ❑ TWO COMPARTMENT ❑ FLOW-THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS.INCLUDED <br /> 2. PUMPING ASSEMBLIES <br /> PUMP is MFG. MODEL (INCLUDE PERFORMANCE CURVE) ❑ <br /> PUMP 2: MFG. MODEL (INCLUDE PERFORMANCE CURVE) ❑ <br /> CONTROL PANEL: MFG. MODEL ❑ <br /> t lYDROSPLITTER: MFG. MODEL (INCLUDE ORIFICE CALCULATIONS) ❑ <br /> EFFLUENT FILTER: MFG. MODEL ❑ <br /> DISTRIBUTION VALVE:MFG. MODEL ❑ <br /> 3. EFFLUENT TRANSPORT PIPING <br /> ❑ GRAVITY EFFLUENT SEWER LENGTH DIAMETER - MATERIAL FALL(IN INCHES) <br /> p(, PRESSURE PIPING: LENGTH `/G 1 DIAMETER 11.7? MATERIAL (VC._ PSI ,71J <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: , EQUAL 0 LOOP 0 SERIAL ❑ PRESSURIZED <br /> TOTAL LINEAR FOO CAQE: I50 <br /> DBAugitiggpt: ❑GRAVEL-LESS ABSORPTION METHOD BOCK&PIPE ❑OTHER <br /> TOTAL DEPTH 17 DEPTH BELOW PIPE A <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SURFACE): MIN MAX <br /> LNG FILL DEPTH(DEPTH OF CAPI: I lQ" <br /> SETBACKS FROM WELLS: SEPTIC TANK J SAND FILTER OR ATT UNIT 5G 1-i- DRAINFIELD (CC -1- <br /> 5. DEWATERING SYSTEMS(IF REQUIRED) <br /> ❑ CURTAIN DRAIN 0 TILE DEWATERING <br /> TRENCH DEPTH: <br /> DRAIN MEDIA: ❑ PIPE ❑OTHER 1\' i <br /> TAL DEPTH DEPTH BELOW PIPE ❑ FILTER FABRIC <br /> E P I : DIAMETER MATERIAL 01\'\\r <br /> 6. ADVANCED TREATMENT UNITS D <br /> 0 SAND FILTER 0 RGF ATT: TYPE J' ( Yj t C1� l x 'j ( (,( V 11 1� <br /> ❑:\FORMSISEPTICIFORMSLS-60 MATERIALS LIST.DOCX Rev 3/18 �l ._ <br />