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ww <br /> ' � :• MARION COUNTY BUILDING INSPECTION IMPLY-LUL A U11V—III D.P.,WALTR.0X 1Liv1 isms-Antis <br /> -- 5155 Merton Rd NE (to be completedtC0 by system� installer) <br /> 50 47305 PER IITNO.tocJ 5- d ✓✓7 ✓ <br /> c=MARION <br /> COUNTY J/www.co marlomor es/PW/Boii ffio t —gall"°II SITE ADDRESS <br /> Tut of- 19a <br /> AS-BUILT PLAN OF CONSTRUCTED SYSTEM: <br /> Seale:1"= 10' T 1 <br /> Nora <br /> • <br /> • <br /> - - , - <br /> • <br /> - 7 0 <br /> ff`. . 't <br /> 9/0' <br /> - - / - <br /> �. . �3' O y /c--0 - fobO j1.,' /00 - <br /> /1 X / <br /> . - - <br /> (showall details and dimensions necessary to locate all components of the system in the future) <br /> SYSTEM MATERIALS AND SPECIFICATIONS: INSTALLERS CERTIFICATION; <br /> System Design Sewage glow li Gallons/Day IHEREBY CERTIFY THAT THE ON-SITE SEWAGE SYSTEM IN-. <br /> STALLED AT THE ABOVE ADDRESS WAS CONSTRUCTED IN ACCOR- <br /> Septic Tank Size UM gallons motictiTtitit, Mfg 1 11N41.1 DANCE WITH THE REQUIREMENT'S OF THE PERMIT AND THE RULES <br /> OF THE ENVIRONMENTAL QUALITY COMMISSION. <br /> Dosing Tani=-Size gallons Marl Mfg <br /> I have tested the septic tank and certify it to be watertight - <br /> ATT Mahe and Model Bas(ea): <br /> m DistAutirm Th system was installedby. <br /> Emuent Sewer:Size Marl ICI DIV. Property Owner(matinee) <br /> 401Conerete <br /> Drabisdd Pipe:Suet 04lastic I Lim Sewage Disposal Service <br /> Material:HeaderPipe -PerforatedPipe DEQ License Ntmtb= <br /> Total Draiat'reld Footage o7a 5 Tiench Depth Mminmm/ I t M 6'i DEQ Certification Number: - <br /> RoekDoptteTotal Under v1Curtain Drain Depth . <br /> Alternative pralnileld Materhds b•1 ' —'- . Sign <br /> Effluent Pump:Pomp Model ' . - Company name:_00J-he I• . 'H <br /> Pomp Cycle miomtes --.minutes • <br /> Time on off Gallons per Cycle (Please Pam) � - <br /> Attach an additiondaheodforcon�onentsandmaterialsootitstedabove. -_ -____ _ ._Date: S-2'.2695 -�- -.--(For Marlon County Use Only) V �� <br /> above septic system has been inspected by Marion County.The information has been detprmined to be accurate and the system is: <br /> !APPro [ 1 Approved with corrections:see i,:' .,;.n report [ l Denial <br /> Signed: :. _ ` Title: _14 b Date- �� �� �2✓ <br /> Ma 5-41 rev:3/03;4/12 W14 WIIITE Marion County;YELLOW.-Owner;PIIabistaller <br />