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I OREGON <br /> <br /> SEPTIC TANK ABANDONMENT <br /> <br /> IECEIVED <br /> OCT ~- 5 199~ <br />MARION COUNTY <br />BUILDING INSPECTION <br /> <br />THE TANK WAS: <br /> ~ REMOVED <br /> <br />[1 <br /> <br />~I.LED <br />(note: the bottom of the rank shoulO be perforated or cr~¢k~d to <br />prohibit the accumulation of surface water in the tank) <br /> <br /> FILL MATERIAL: <br /> [ ] REIECT SAND <br /> [ ] BAR RUN GRAVEL <br /> [ ] CRUSHED ROCK <br /> [ ] OTHER: <br /> <br />ENCLOSE A C*~PY' 0F'~E ~UMPING RECEIPT WITH~[I'~FORM7 <br /> <br />COMPANY NAME: ~'/~"~ ~rT{J~Yg~/7~'Tf <br />S I ON E D~~~//~ DATE: <br /> <br /> M~ion Coun~ Buildi~ I~ction <br /> 3~0 ~mr Dr. NE, Suite C <br /> Salem, Otegm 9~305-1398 <br /> Phone: 588-5147 <br /> <br />abandon.tnk 4~97 <br />MC-15-S2 <br /> <br /> <br />