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INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (~o be completed by system installer) <br /> <br /> l <br /> / <br />~p~i~ Ta~k: Size: ~ · SY~M INST~L~D AT T~E ~OVE ~DRESS WAS CON- <br />Material: ~~ STRUCTED IN ACCORD~C~ WITM T~ REQUIREMENTS OF <br />Manufacturer: ~~ T~E PE~IT ~D T~E RULES OF T~ ~IRO~ENT~ <br />MaterialL,, ~ ~ ~Q~ ~ I have tested the sep%ic tank and certify <br />Box (~s): T~e: <br /> it to be0watertight, <br />Di,~ri~ut~on Pipe:Size, ~" <br />Material L, <br /> <br />(for Marion County use only) <br /> <br />The above septic system has been inspected by Marion County. The information has been determined <br /> <br /> ~o be accurate and the system <br /> [~<~ Approved <br /> [ ] Approved <br /> [ ] Denied <br /> <br /> Signed: <br />as-built,rrm 3/95 <br /> <br /> <br />