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:,,,,, Marion County Date:06/17/2024 <br /> OREGON <br /> IPUBLIC WORKS <br /> Marion County Onsite <br /> Wastewater Site Review <br /> Tax Lot# <br /> Address 4666 Libby LN SE, Jefferson <br /> 092W320000800 <br /> Activity Minor Repair <br /> 36 <br /> Parcel Size 5. Acres <br /> Number 555- 24-004269 <br /> Completed by Matt Knudsen, REHS <br /> An evaluation of the test holes dug for soil analysis was conducted on 6/13/24 <br /> The conditions observed during this site evaluation indicate that the area around the evaluated test <br /> holes IS capable of supporting a standard septic system. <br /> Under these conditions a Standard <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 3BDRM Single Family Dwelling <br /> The maximum daily flow into the system is 375 gallons per day. <br /> The following documents are required to issue this permit (this checklist is for your own record keeping): <br /> El Plot Plan ❑ <br /> El Materials List <br /> nProduct Specifications ❑ <br /> ❑ ❑ <br /> **See Reverse for Notes or Special Conditions** <br />