Laserfiche WebLink
INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br />'~ (to be completed by system installer) <br /> <br />~-~UILT P~ OP CONSTRUCTED SYST~: <br /> <br /> (show all d~Uai,!s and dimensions necessary to locate all components of the system in the <br /> <br /> F~ATE~IALS LIST FOR SYST~: INST~LERS ~RTI~I~TION: <br /> I I HEREBY CERTIFY T~T THE ON~SIT~ SEWAGE <br />8Optic TaURi Size: /~ ~~ SYST~ INST~LEO AT TaE ~OVE ~DRESS WAS CON- <br />Material: ~W~ STRU~ZD IN ACCORD~CE WITH THE REQUIREMENTS <br />Manufacturer: ~Ft'{~F THE PE~IT ~D THE RULES OF THE E~IRO~ENT~ <br />Effluent Sewer: Size: l~ ~e . QU~ITY <br />Material:,,, ~/ ~ ~d [~ I have tested the septic tank and certify <br />Material: ~~ ~,;& <br />Drain Media: Depth: /~ '6 / ~ Date: <br /> <br />(for Marion County use only) <br /> <br /> ~"ne above septic system has been inspected by Marion County. The informa=ion has been determined <br /> to be accurate a~d the system is: <br /> [~Approved ~ - <br /> [ ] Approved w~%~hi~qrre~ti~s: seg~inspecuion report <br /> [ ] Denied <br /> <br />is-built.frs 3/95 <br /> <br /> <br />