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12014596
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Last modified
3/25/2024 10:53:30 AM
Creation date
1/18/2024 2:01:12 PM
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Permits
Permit Address
10476 SUNNYSIDE RD SE
Permit City
Jefferson
Permit Number
555-21-002316-PRMT
Parcel Number
093W10A 00801
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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Marion County Public Works <br /> Building Inspection Division 2�,o�3i� <br /> 5155 Silverton Rd NE <br /> reo Salem OR 97305 <br /> (503) 588-5147 Fax(503) 588-7948 <br /> http://www/co.marion.or.us <br /> EXPIRED <br /> ON-SITE SYSTEM MATERIAL LIST <br /> (DIRECTIONS&DEFINITIONS ON BACK) <br /> ADDRESS TAX LOT# <br /> SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS <br /> SEPTIC TANK: MFG. k)4/ J CAPACITY .Z400 MATERIAL C..W G <br /> ❑ DOSING TANK:MFG. CAPACITY MATERIAL <br /> ❑ SEPTIC/DOSING TANK: 0 SINGLE COMPARTMENT 0 TWO COMPARTMENT ❑ FLOW-THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS. INCLUDED <br /> 2. PUMPING ASSEMBLIES <br /> PUMP 1: MFG. MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> PUMP 2: MFG. • MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> CONTROL PANEL: MFG. 6; I MODEL SC< /'�ln Gam. ❑ <br /> HYDROSPLITTER: MFG. MODEL f1INCLUDE ORIFICE CALCULATIONS) 0 <br /> EFFLUENT FILTER: MFG. MODEL ❑ <br /> DISTRIBUTION VALVE:MFG. MODEL 0 <br /> 3. EFFLUENT TRANSPORT PIPING <br /> ❑ GRAVITY EFFLUENT SEWER: LENGTH DIAMETER MATERIAL FALL(IN INCHES) <br /> ❑ PRESSURE PIPING: LENGTH DIAMETER MATERIAL PSI <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: ❑ EQUAL ❑ LOOP 0 SERIAL 0 PRESSURIZED <br /> TOTAL LINEAR FOOTAGE: <br /> DRAIN MEDIA: 0 GRAVEL-LESS ABSORPTION METHOD 0 ROCK&PIPE ❑OTHER <br /> TOTAL DEPTH DEPTH BELOW PIPE <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SURFACE): MIN MAX <br /> CAPPING FILL DEPTH(DEPTH OF CAP): <br /> SETBACKS FROM WELLS: SEPTIC TANK SAND FILTER OR ATT UNIT DRAINFIELD <br /> 5. DEWATERING SYSTEMS(IF REQUIRED) <br /> ❑ CURTAIN DRAIN 0 TILE DEWATERING <br /> TRENCH DEPTH: <br /> DRAIN MEDIA: 0 ROCK&PIPE ❑OTHER <br /> TOTAL DEPTH DEPTH BELOW PIPE 0 FILTER FABRIC <br /> PERFORATED PIPING: DIAMETER MATERIAL <br /> 6. ADVANCED TREATMENT UNITS <br /> ❑ SAND FILTER ❑ 'RGF ❑ ATT: TYPE <br /> G:\FORMS\SEPTIC\FORMS\S-60 MATERIALS LIST.DOCX Rev 3/18 <br />
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