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SIT'ADDRESS: <br /> <br />INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br />AS-BUILT pLA/~ OF CONSTRUCTED SYSTEM: <br /> <br />scale: 1" = <br /> <br />North <br /> <br />l <br /> <br />L <br /> <br />I <br /> <br />(show all details and dimensions necessary to locate all components of the system in the future) <br /> <br /> Met'l: Mfg: <br /> <br />Drop / [~ Concrete; [ ] Plastic <br /> <br />Mater,&l: Header: ~ ; Perf:__ <br /> <br /> (for Marion Coun=y use only) <br /> The above septic system has been inspected by Marion County. The information has been determined <br /> to be accurate and the system is: <br /> ]Approved <br /> Approved with corrections: see inspection report <br /> <br /> ~ig~ed :l~'~{~''' 4 ~ Title: Date: <br />~s-built.frm 4/95 WHITE:Marion County; YELLOW:Owner; ~INK:Installer <br />MC-15-S~i <br /> <br /> <br />