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<br /> :... ..,... .,..:..:.•:. MAR.MIK:COVNTY'attLb.IN6INSPEOION.
<br /> $1S5,Silvertortlid:NE
<br /> SALEM OR 9740,5
<br /> cliValiall ': INDIVIIII1AL ON-SITE SEWAOESYSTE14 :ItECOlds,'(tti,..1i#: (iiiipletedi4k:$igteitiliittaller)',
<br /> —.
<br /> SITE ADDRESS (O..I 1 713.4o,44k .c,,Yk. .0 PERMIT NO. 6-67• R."1' 0039 4,3• 1' ,1-17-
<br /> AS43UILT PLAN,OF CONSTRICTED SYSTEM:::
<br /> •Scite:iii 7.41,15..
<br /> North 1 .....
<br /> •
<br /> li
<br /> 5 ec
<br /> ,....._
<br /> .. .
<br /> • • - • • " - -- ••••••, - - •. .. .tshow.:Alt details and•.dirnensons 16-0'qtri1I ddiritonOnt. tif th0;0. tdifi iii,ThOluiur.e): .
<br /> SVSTEM:MATERIALSANWSFECIFICATIONSi. INSTALLERS CERTIFICATION: •
<br /> .....:. . ,. .. ., . .. _
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<br /> i r.,. ... . .
<br /> SyateitiVeaida'Se1/200 Flow . 71 3(--/ OallonstDay I HEREBY CERTIFY./ DANCETHATTHEON-SITESEWAGESYSTEM IN-
<br /> STALLEDAT .. . , _ SR
<br /> .„ . , , .... .
<br /> TNE ABOVE ADDRESS NASCONTIXTED-INACQDR-
<br /> Septic-Tank Size l,0.47.0 :Matt 6:Me$/'.1( MI'gf AAA4e , , __.,....THEREOUIREMENTS OF -.....HE:OE ...
<br /> WITHIItiVilTAND THE RULES
<br /> . „
<br /> or THE ENVIRONMENTAL QUALITY COMMISSION:
<br /> Dbaing-Taiik::Siii:.: . . . Mat t . . . : :'Mfg:: :14.I haVdtested;thek'plie tank and certify.it Iti-iia'Watettigg,
<br /> . .. .
<br /> Alternatiye,TreatmentTcchmitogy:-4 ..x ':. :6 VtThe . ._ . . ... .
<br /> ' system Was;,installedk by:
<br /> ... ., ,
<br /> ' I VPTDPc:TYcvmer,(min4ec). .,
<br /> EihoentSeiitert:si. qt. .Met:3:4 7)4I. Fit.. : KLicensagcw4geDisposii:Setvice
<br /> 0.:!*s);..)0iiiiitioitOn: 1 1,D.rep.I t t:Cantrete:, t t Plastic DEQ License Nattibeitz: 3:''. Lii457.
<br /> .... .:. .:....,- . : • . . . .
<br /> Drainfield.-FiOe::Si#:'kt .,Material:Mad,eit'30-,-.N4: !..Porf., ..., . :DEO Certification Number ‘ R.j_ „ . 1 1
<br /> ... .
<br /> Total:DrainfieldFatitage: .20: :Rock.:.beptk'Totai-. Under Pipe 14 . -- A
<br /> . .
<br /> Signod:.,. ,.
<br /> ,AltertiativeDraiitlieldMaterialat El,.11..1.o y.- Gto. • ,
<br /> _.
<br /> Trench Depth 3 4.,:maxiintim,1) Curtain Drain beptir, Company nanie:N(44. 1.-117t.... tt.)•:),VirtA,-CliC4-\
<br /> (please print) . . . .
<br /> Effluent Pump f Pump Model: Static Head in System _ _ „ „ . .A. Data. —) 1 / ci./az v .
<br /> , .f f 41
<br /> -2,Ftpp,CyeleTlipe: - - :..Ciallonsper,,,Ccia::.Attackart5aiitlitiatialiaitettforieomtionent.4 and itiaterials-not-liated'abo-,;:c. , .,
<br /> ... ,
<br /> (-FO.17-34RilOR;COURiy-te only)•:
<br /> •
<br /> 717. ..abov.e-septic.vienf.has been=inspected by Marion OgipirAy..ThinfOrptipp has .heelti-:deterOutied-tOb4atdurate andthsystem.is:
<br /> I Approved
<br /> ..I/
<br /> [I Approved with corrections see inspection report.
<br /> . 1.1 benied. .
<br /> Signed:: %....., - 7-'-.-- --.Ilitet. f-W. -63T„ leTZ;3761- 3e. :D4tet.
<br /> Kg!,.54 1 ' '' t*:3Y..054:412-• WHITE:Marlan',Volovy;Ygl:,40.1f,,0**k;PI:Arlc16..i.t4101.4
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