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MARION COUNTY HEALTH DEPT. -Sanitation Specifications ._'3 ~ ~ <br /> 4--30--74 mob'1 le home '~ ...... Numbe~ ~ ,,~ <br /> <br /> [ ~ ~ Signoture <br /> <br /> RECORD OF INDIVIDUAL SEWAGE DISPOSAL SYSTEM <br /> <br />~,~nk'. Distance from welt ............................ it, Material ............ ~..,F./3C.~J~.,..~,,~, ........................................................... <br /> <br /> Tom] liquid c~pacit¥ .~.~.,~.,,~, .............. q~ls. <br />Tile disposal tield: <br /> <br /> To~l length of ~1~ line~ ......~ ................ fl, <br /> Width of ~rench ................. ~,,~..ff~ .............................. <br /> Dfetcnee between line~ ................ ~,~ ....................... <br /> <br />CLF~LN NO. 2 ROCK; <br />Depth under tile ............ ~ .................... inches, <br />Depth over tile ............. ~., ................... inches. <br /> De~th el tfle below oriqtncd ground ~urfc~e ............ ~...,¥, .......... inches, <br /> <br />Well ........................................ fl, <br /> <br /> Lot line: Front ~ Side <br /> Toundation ........................................ <br /> <br />fleet [] ............................ fi, <br /> <br />Sketch of Installation (show lo¢~tion of ro~d, house ~nd ~epti¢ ~y~tem) <br /> <br />(FOR I{~AI, TH D~:PT. USE) <br /> <br /> <br />