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INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br />AS-BUILT PLAN OF CONSTRUCTED SYSTEM: <br /> <br />scale: 1" = 2~ <br /> <br />{show all details and dimensions necessary to locate all components of the <br /> <br />MARION COUNTY <br /> <br /> se~ase m~, ~ <br /> <br />s~:: si~: I~~' ~t,:: PVC <br />Distribution; [ ] D~op / [ ] Concrete; ~ Plastic <br /> <br /> Minimum: ~ ; Maxi=m:~ ; Curtain Drain ~pth: <br /> ~ Model:~S I ; Static He~d in System; <br /> <br /> ~ ~cle Time:~; Gallons per ~cle: <br /> <br /> Gallons/Day <br /> <br />Mfg. ~ <br /> <br /> DSO Licen.e Number: %~)~7 <br /> <br />Company name: A4%,,e'.- tlc_ <br /> Date: ~/~/O ~ <br /> <br /> (£or Marion County uss only) <br /> The above septic system has been inspected by Marion County. The information has been determined to be accurate and <br /> the system is: <br /> ~] Appr°V~r;:e <br /> ~[:3 tree S: se: inspection report <br /> <br />Rev 4/98 <br /> <br />Title Date: '~ I [. ~ <br /> - }flrml~r r <br /> W~ITE:Marion County; YELLOW:Owner; ~INK:Ir~taller <br /> <br /> <br />