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SITE ~DRESS: <br /> <br />INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br />A~-BUILT PLAN OF CONSTRDL-z'~D SYSTEM: <br /> <br /> ! <br />North <br /> <br />(show all details and dimensions necessary to locate all com <br /> <br />Gallons/Day <br /> <br />[ ) Drop / [ ] Concrete; [ ] Plastic <br /> <br /> ; Static Head in System; Ft. <br /> <br />)onents of the system in the future) <br /> <br />Signed~ <br /> <br />(please print) <br /> <br /> D.te: <br /> <br /> (£or Marion County uae only) ~ <br />The abovs septic system has been inspected by Marion County. The 'n~ormati has been determined to be accu and <br /> <br /> Approved ~ <br /> [ ] Approved with ~tions: see inspection report <br /> <br /> Date: <br /> <br />MC15-S41 County; YELLOW:Owner; PINK:Installer <br />Rev 4/98 <br /> <br /> <br />