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MARION COUNTY HEAETH~P~ -Sanitation Specificat <br />r~te 7-~QrT~ DUPLICATE Nuraber ............ 43~ <br /> <br />Subsurface dis~sal field require~ ~ iin :t,~ w~dth o~ t~nch <br />Other ;e~lremenm AS per approved plo~ pl~ September 197~ curtain drain a~o~nd system. <br /> <br /> Issued by Robert Foster <br /> <br /> RECORD OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM <br />TO BE COMPLr~r~D BY INSTAI.LI~ /~,, . <br /> <br />Septic tank' Distance f~m well ~ ,h Mate~al <br /> <br />/¢~o ~ 74-0 Tet~,~ liquid cap,:city ~7,~'~,~2),,,,, ~J~l~,, <br /> Ti:e dlsPO~$C~l field /~ / <br /> Lgnqth el e~ch line <br /> <br /> Total length of all lines ~.,~ fi, <br /> <br /> Width oi trench f~ <br /> Distance between lme~ /~.~ ~, <br /> <br />wen '~,,~ .............. f~,, <br /> <br /> Lot line: Front [] Side [] Rear [] ~c~- tt <br /> ~oundaIlo~ ...... ~'~-0. f .......... ~, <br /> <br /> Inspection wiD not be made until completed form <br /> <br />DAT~--'~ -- ~-~- Signature <br /> <br />System appamn~ wlil ~ w,il not <br /> Di~gpp~ved <br /> <br /> ~ , ~RIO Y <br /> <br />Copy (1) Orl~al ~ MCHD files <br /> <br /> (31 Phk -- ~st~ller (SANITARIAN) <br />EH~43 11/71 <br /> <br /> <br />