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, Marion County Public Works <br /> • ��I ''` • <br /> '����,,� Building Inspection Division <br /> ����—���_ 5155 Silverton Rd NE ' <br /> • ������` Salem OR 97305 • <br /> • (503)588-5147 Fax(503)588-7948 <br /> http://www/co.marion.or.us <br /> • <br /> ON-SITE SYSTEM MATERIAL LIST <br /> • (DIRECTIONS&DEFINITIONS ON BACK) <br /> ADDRESS OZ 51 1 }Y �10o 6%.1-e- Y Se- TAX LOT# <br /> SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS , ` ,�,. <br /> SEPTIC TANK MFG. `,J a• `- CAPACITY 'C:)( O MATERIAL C .� <br /> ❑ DOSING TANK MFG. CAPACITY MATERIAL <br /> 0 SEPTIC/DOSING TANK 0 SINGLE COMPARTMENT 0 TWO COMPARTMENT ❑ FLOW-THROUGH <br /> MFG. CAPACITY MATERIAL <br /> JUIFG.'S SPECS. INCLUDED <br /> 2. PUMPING ASSEMBUES • <br /> PUMP 1: MFG. MODEL (INCLUDE PERFORMANCE CURVE) ❑ <br /> PUMP 2: MFG. MODEL (INCLUDE PERFORMANCE CURVE) . ❑ <br /> CONTROL PANEL.: MFG. • MODEL • p <br /> J VDROSPLITTER: MFG. MODEL (INCLUDE ORIFICE CALCULATIONS) 0 <br /> EFFLUENT FILTER: MFG. MODEL 0 <br /> DISTRIBUTION VALVE:MFG. MODEL 0 <br /> 3. EFFLUENT TRANSPORT PIPING • <br /> ❑ GRAVITY EFFLUENT SEWER: LENGTH DIAMETER MATERIAL FALL(IN INCHES) <br /> 0 PRESSURE PIPING:.LENGTH DIAMETER MATERIAL 'PSI <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: 0 EQUAL 0 LOOP 0 SERIAL ❑ PRESSURIZED <br /> TOTAL LINEAR FOOTAGE: <br /> DRAIN MEDIA 0 GRAVEL-LESS ABSORPTION METHOD 0 ROCK&PIPE 0 OTHER <br /> TOTAL DEPTH DEPTH BELOW PIPE <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SURFACE): MIN MAX <br /> CAPPING FILL DEPTH(DEPTH OF CAP): <br /> SETBACKS FROM WELLS: SEPTIC TANK 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 . 0 OTHER • • <br /> TOTAL DEPTH DEPTH BELOW PIPE 0 FILTER FABRIC <br /> PERFORATED PIPING: DIAMETER • MATERIAL ` <br /> 6.. ADVANCED TREATMENT UNITS c <br /> ❑• SAND FILTER 0 'RGF ❑ NTT: TYPE <br /> • \?• <br /> 0:IFORMSISEPTICIFORMS\S-¢0 MATERIALS LIST.DOCX Rev 3/18 <br />