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Marion County Public Works 1 q -CO \2- -i?0,..t <br /> 44 , <br /> Edi, ".'w„ Building Inspection Division <br /> 11� 1� 5155 Silverton Rd NE p C E V <br /> ,-,, •� Salem OR 97305 <br /> Tom? T' <br /> (503)588-5147 Fax(503)588-7948 OCT 24 2018 <br /> MI http://wwwico.marion.or.us <br /> • <br /> MARION COUNTY16 <br /> BUILDING INSPECTION <br /> ON-SITE SYSTEM MATERIAL LIST <br /> (DIRECTIONS&DEFINITIONS ON BACK) <br /> ADDRESS2?O7 R061//?S Li) 5t TAX LOT# <br /> SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS / • <br /> OA <br /> /y.Air ,Q <br /> j X-SEPTIC TANK: MFG �/ /1 1 dk CAPACITY ' / l MATERIAL LOQ" t (- * <br /> { ❑ DOSING TANK:MFG. CAPACITY `" MATERIAL <br /> ❑ SEPTIC/DOSING TANK: 0 SINGLE COMPARTMENT ❑ TWO;COMPARTMENT 0 FLOW-THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS.INCLUDED <br /> 2. PUMPING ASSEMBLIES <br /> PUMP 1: MFG. MOD A (INCLUDE PERFORMANCE CURVE) ❑ <br /> PUMP 2: MFG. J MOI L A (INCLUDE PERFORMANCE CURVE) 0 <br /> CONTROL PANEL: MFG. I_ Mu 0 <br /> HYDROSPLITTER: MFG. a- ODEL AI (INCLUDE ORIFICE CALCULATIONS) ❑ <br /> EFFLUENT FILTER: MFG. 4.. ODE• D <br /> DISTRIBUTION VALVE MFG. MOD L ❑ <br /> 3. EFFLUENT TRANSPORT PIPING <br /> • <br /> (GRAVITY EFFLUENT SEWER: LENGTH (00 DIAMETER q MATERIAL 7PY FALL(IN INCHES) /9 <br /> ❑ PRESSURE PIPING: LENGTH DIAMETER MATERIAL PSI <br /> 4. DISPOSAL FIELD(DRAINFIELD) `�y�1c, <br /> DISTRIBUTION TECHNIQUE: E UAL r. 0 LOOP SERIAL 0 PRESSURIZED <br /> TOTAL LINEAR FOOTAGE: Fibc-, <br /> DRAIN MEDIA: ❑GRAVEL-LESS ABSORPTION METHOD ❑ROCK&PIPE ❑OTHER f� <br /> TOTAL DEPTH DEPTH BELOW PIPE • n <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SURFACEI: MIN A 9 �� MAX 30 <br /> CAPPING FILL DEPTH(DEPTH OF CAP]: <br /> SETBACKS FROM WELLS: SEPTIC TANK /2[) 1 SAND FILTER OR ATT UNIT DRAINFIELD <br /> 5. DEWATERING SYSTEMS(IF REQUIRED) <br /> ❑ CURTAIN DRAIN 0 TILE DEWATERING <br /> TRENCH DEPTH: <br /> DRAIN MEDIA: 0 ROCK&PIPE ❑OTHER • <br /> TOTAL DEPTH DEPTH BELOW PIPE ❑ FILTER FABRIC <br /> PERFORATED PIPING: DIAMETER MATERIAL <br /> 6. ADVANCED TREATMENT UNITS <br /> O SAND FILTER ❑ 'RGF 0 ATT: TYPE <br /> G:IFORMSISEPTICIFORMSIS-¢0 MATERIALS LIST.DOCX Rcv 3/18 <br />