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Marion County Public Works <br /> oil ��'''��� Building Inspection Division <br /> 5155 Silverton Rd NE <br /> Salem OR 97305 <br /> (503) 588-5147 Fax(503)588-7948 <br /> http://vvww/co.marion.orus <br /> ON-SITE SYSTEM MATERIAL LIST <br /> (DIRECTIONS&DEFINITIONS ON BACK) <br /> ADDRESS 1 Q S N e,(1 ct•rd L' f TAX LOT# <br /> SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS . . <br /> • X SEPTIC TANK: MFG. . I h 1+i (��` •r <br /> CAPACITY, I 0 O 0 U,l MATERIAL pots/ <br /> ❑ DOSING TANK:MFG. CAPACITY MATERIAL <br /> 0 SEPTIC/DOSING TANK 0 SINGLE COMPARTMENT 0 TWO COMPARTMENT 0 FLOW-THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS. INCLUDED <br /> 2. PUMPING ASSEMBLIES <br /> PUMP 1: MFG. N/A MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> PUMP 2: MFG. MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> CONTROL PANEL: MFG. MODEL ❑ <br /> HYDROSPLITTER: MFG. MODEL (INCLUDE ORIFICE CALCULATIONS) 0 <br /> EFFLUENT FILTER: MFG. MODEL ❑ <br /> DISTRIBUTION VALVE:MFG. MODEL ❑ <br /> 3. EFFLUENT TRANSPORT PIPING �5 �cl? 'N ��R �/ � "��� ' l$ <br /> 1/"‘ EFFLUENT SEWER: LENGTH g-9,5" <br /> DIAMETER 6 MATERIAL" = FALL(IN INCHES) <br /> ❑ PRESSURE PIPING: LENGTH DIAMETER MATERIAL PSI <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: 0 EQUAL 0 LOOP 0 SERIAL 0 PRESSURIZED <br /> L.----TOTAL LINEAR FOOTAGE: 2-.1-5 <br /> C.-DRAIN MEDIA: ❑GRAVEL-LESS ABSORPTION METHOD 0 ROCK&PIPE 7330THER P1°w <br /> TOTAL DEPTH DEPTH BELOW PIPE <br /> .TRENCH DEPTH(FROM ORIGINAL GROUND SURFACE): MIN LL1$� MAX �y <br /> CAPPING FILL DEPTH(DEPTH OF CAP): <br /> SETBACKS FROM WELLS: SEPTIC TANK i'/f4 SAND FILTER OR ATT UNIT DRAINFIELD <br /> f -- <br /> 5. DEWATERING SYSTEMS(IF REQUIRED) <br /> ❑ CURTAIN DRAIN ❑ TILE DEWATERING <br /> TRENCH DEPTH: <br /> DRAIN MEDIA: 0 ROCK&PIPE 0 OTHER • <br /> TOTAL DEPTH DEPTH BELOW PIPE ❑ FILTER FABRIC <br /> PERFORATED PIPING: DIAMETER MATERIAL <br /> 6. ADVANCED TREATMENT UNITS <br /> 0 SAND FILTER 0 'RGF 0 ATT: TYPE • <br /> WORMS MATERIALS LIST.DOCX Rev 3/18 <br />