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r a <br /> Marion County Public Works <br /> Bt.11ding Inspection Division <br /> 5155 Si!vertan Rd • <br /> Salem OR 97305 • <br /> (503)588-5147 Fax(503)588-7948 <br /> http://wwwlco,mar)on.or.us <br /> e / ' <br /> • <br /> ON-SITE SYSTEM MATERIAL LIST <br /> (DIRECTIONS&DEFINITIONS ON BACK) <br /> ADDRESS 5 71 s s‘c"e L 1 5E ,4c3t•-•su \- TAX LOT# 13 C_ 8 a'- P 3oo <br /> SECTION TOWNSVIP RANGE LOT <br /> 1. SEPTIC TANKS <br /> • K.SEPTIC TANK: MFG. Lk,_• Cr.• CAPACITY• l Q 0 G MATERIAL C O in c.c.G-k-e• <br /> ❑ DOSJNG TANK:MFG. • CAPACITY MATERIAL <br /> ❑ SEPTICIDO SING TANK*. 0 SINGLE COMPARTM=NT ❑ TWO COMPARTMENT 0 FLOW THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS.INCLUDED <br /> 2. PUMPING ASSEMBLIES • <br /> • <br /> PUMP 1: MFG. 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 0 <br /> DISTRIBUTION VALVE:MFG. MODEL 0 <br /> 3. EFFLUENT TRANSPORT PIPING 3D3q <br /> O GRAVITY EFFLUENT SEWER: LENGTH - DIAMETER MATERIAL FALL(IN INC IES) <br /> ❑ PRESSURE PIPING: LENGTH DIAMETER MATERIAL •PSI <br /> 4. DISPOSAL FIELD(DRAINFIELD) •�-�,�Q <br /> DISTRIBUTION TECHNIQUE: 0 EQUAL 0 LOOP 0 SERIAL 0 PRESSU IZED <br /> TOTAL LINEAR FOOTAGE: <br /> DRAIN MEDIA: 0 GRAVEL-LESS ABSORPTION METHOD ❑ROCK&PIPE 0 OTHER • <br /> TOTAL DEPTH DEPTH BELOW PIPE • <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SURFACI): MIN MAX <br /> CAPPING FILL DEPTH(DEPTH OF CAP't: _ <br /> SETBACKS FROM WELLS: SEPTIC TANK _ SAND FILTER OR ATI-UNIT DRAINFIELD�• <br /> 5. DEWATERING SYSTEMS(IF REQUIRED) <br /> ❑ 'CURTAIN DRAIN ❑ TILE DEWATERING <br /> TRF,NCH DEPTH: <br /> DRAIN MEDIA: 0 ROCK&PIPE 0 OTHER_ • <br /> TOTAL DEPTH DEPTH BELOW PIPE 0 FILTER FABRIC <br /> PERFORATED PIPING: DIAMETER MATERIAL <br /> 6. ADVANCED TREATMENT UNITS <br /> O SAND FILTER 0 'RGF 0 ATT: TYPE <br /> 0:\FORMSISEPTICTORMSIS-60 MATERIAIS LIST.DOCX Rev 3/18 <br />