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INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br />A~-BUI¥,~ PLAN O~ CONSTRUCTED <br /> <br />scale: 1" = ~ ' <br /> <br /> ! <br />North <br /> <br />(show all details and dimensions necessary to locate all components of the system in the future) <br /> <br />Tank: Size: <br /> <br />~ ~OO Gallons/Day <br /> <br />Mar'l: Mfs: <br /> <br /> [ ] Plastic <br /> <br />Sox(es): [~] Distribution; [~] Drop / [ ] Concrete; <br />Drainfiela Pipe: Size: ~SS; ~te~i&l: Reader:.~ga~ ; Perf:_~ga~ <br />Total Dr&infie~d Fo~tag.:~; Rock D.pth: Total: /-~"; Under pipe: <br />Trench Dept~: Minimum: /~ ; M~i~m: ~ ; Curtain Drain Depth: <br />Effluent P~; Pump Model: ; Static Read in System: <br /> <br /> Pump ~cle Time: ; Gallons per Cycle: <br /> <br /> T ON: <br /> I RERESY CERTIFY THAT TRE ON-SITE SEWAGE <br />SYSTEM INSTAi~ED AT TRE ABOVE ADDRESS WAS CON- <br />STRUCTED IN ACCORDANCE WITR %~E REQUIREMENTS OF <br />TRE PERMIT AND THE RI/LES OF THE ENVIRONMENTAL <br />QGUA~TY CO~94ISSION. <br />£~I have tested the septic tank and certify <br /> it to be watertight. <br /> <br />The system was installed by: <br />[ ] Property Owner (permitee) <br /> <br /> (for Marion County use 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 /> ~ ~th torsions: see inspection report <br /> <br /> ' <br />Rev 4/98 ~ <br /> <br />WHITE:Marion County; YELLOW:Owner; P~NK: ~nstaller <br /> <br /> <br />