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SITE ADDRESS: <br /> <br />INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br />North <br /> <br />A~-BUILT PLAN OF CONSTRUCTED SYST~: <br /> scale: 1" = ~ <br /> <br />(show all details and dimensions necessary to locate all components of the system in the future) <br /> <br />BOX(ms): [ ] Distribution; [ ] Drop / [ ] Concrete; [ ] Plastic <br /> <br />Tr~h D~pTJ=~ Minimum: ; Maxi~m: ; Curtain Drain Depth: <br /> <br />a~HE PERMIT AND THE RULES OF THE ENVIR0~A~ <br /> <br />~ DEQ License Number: ~q 7 7 <br /> <br /> Co.any name: OA N~ ~ &~ <br /> <br />I (£or Marion County uss only) <br /> The above septic system has been inspected by Marion County. The information b n ets ' ~ to be accurate and <br /> <br /> ~-Appr~ ~ e ~ns ectlon re orr ' ' ! <br />II [ ] App~Dveuj~n Corrections: se ' p ' p <br /> <br />~e~ ~/~ ~ <br /> <br /> <br />