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�,,�tt Marion County Public Works <br /> (III i��,,,i Building Inspection Division • <br /> =',—��1 �`_ 5155 Silverton Rd NE <br /> Salem OR 97305 • <br /> 3 -(50 ) 588-5147 Fax(503)588 7948 <br /> http://www/co.marion.or.us <br /> ON-SITE SYSTEM MATERIAL LIST - <br /> (DIRECTIONS&DEFINITIONS ON BACK) <br /> ADDRESS 747 rirkeir. coa471, TAX LOT# <br /> 100200. SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS <br /> SEPTIC TANK: MFG. .g g., CAPACITY / 412 MATERIAL. Caner a <br /> ❑ DOSING TANK:MFG. • CAPACITY MATERIAL <br /> O 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. MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> PUMP 2: MFG. MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> CONTROL PANEL: MFG. MODEL 0 <br /> HYDROSPLITTER: MFG. MODEL -IptINCLUDE ORIFICE CALCULATIONS) 0 <br /> EFFLUENT FILTER: MFG. MODEL • 0 <br /> DISTRIBUTION VALVE:MFG. MODEL ❑ <br /> 3. EFFLUENT TRANSPORT PIPING • <br /> ® �g <br /> &GRAVITY EFFLUENT SEWER: LENGTH �® DIAMETER MATERIAL Rif FALL(IN INCHES) <br /> ❑ PRESSURE PIPING: LENGTH DIAMETER MATERIAL •PSI <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: EQUAL 0 LOOP 0 SERIAL 0 PRESSURIZED <br /> TOTAL LINEAR FOOTAGE: ? S <br /> DRAIN MEDIA: 0 GRAVEL-LESS ABSORPTION METHOD 0 ROCK&PIPE OTHER r 1 6 <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 AU 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 STATE CERTIFIED <br /> ' <br /> PERFORATED PIPING: DIAMETER MATERIAL Environmental Health Specialist f <br /> • <br /> L: <br /> a• EH—S-102,27575 {- <br /> 6. ADVANCED TREATMENT UNITS a• _ <br /> ❑ SAND FILTER ❑ 'RGF ❑ ATT: TYPE • <br /> Aldan Bammes <br /> G:\FORMS\SEPTIC\FORMS\S-60 MATERIALS LIST.DOCX Rev 3/18 Wile ?& <br />