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MARION COUNTY HEALTH DF-?'T. "' '
<br /> -samtat,on Specifications
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<br />~e~lt I~,~ to; Pac. ~,'~..~.~ Co.. ....................... mo~ ~, ..~:~.~..'[~.~.~.~ ~..,...~
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<br /> RECORD OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM
<br />TO B~ COMPL~Y~D BY IN~ ~ ~ / ~_., t t / ~
<br />,.~-,.~:~=,~ .~ ........... ~.,,,~g~......,z~,~ ...................................................... ~o~o ~.~?.?
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<br /> T~t~ liquid C*p~City ...~.~.~, ........ g~ls,
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<br /> Width o~ ~.~ .................. ~. .................................
<br /> Dlsto~ce b~weon ilne~ ........ ~ .............................
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<br />CLEAN NO. 2 ROCK;
<br />Depth undo~ til~ ......... ~'.... .................... in~s.
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<br /> Depth ovo~ trio .................................... inch~s,
<br /> Depth ~f ~ile below oriqi~ol qrourld surface ......... ,~.,,,~ .................. lnche~.
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<br />Well ........................................ It,
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<br />~ [] ............................ ft,
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<br />System or>pc~renS¥ will ~ will not []
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<br /> (2) Yell~ -- Re~tonee ~,~..,~ ...........
<br />(3) P~k ~ ~a~l~r ,' v (SANITARIAN) .......................................
<br />E~1--43 11/71 ~
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