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11979784
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Last modified
12/15/2023 11:01:59 AM
Creation date
12/14/2023 4:06:31 PM
Metadata
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Permits
Permit Address
21573 CHAMPOEG CREEK LN NE
Permit City
St paul
Permit Number
555-23-001336-PRMT
Parcel Number
042W12 01300
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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• <br /> �• MARION COUNTY BUILDING INSPECTION INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> 5155 Silverton Rd NE (to be completed by system installer) <br /> - - SALEM OR 97305 <br /> 503-588-5147 PERMIT NO. 555-23-001336-PRMT <br /> MARION 21573 Champoeg Creek Ln NE <br /> COUNTY http://www.co.marion.or.us/PW/Buildinglnspection <br /> SITE,. DDRESS: St.Paul Oregon 97137 <br /> AS-BUILT PLAN OF CONSTRUCTED SYSTEM: e- m ® s m � �_ <br /> A. <br /> o T <br /> Scale: tr= h Current Se tic ..° o <br /> ® 2nd Choice 9 North <br /> As Built Map , ®.® ,• . Proposed , <br /> Drain Field .0 <br /> ® 1st Choice a,a a r a®a Replacement ♦ Nt <br /> Proposed a a a rea ♦ <br /> A Drain Field -.,a a B <br /> Replacement r-" ®o® B <br /> d <br /> ,'0 Area • .•w••i.°•_ Elevation at Site 176 ft <br /> s . •• .MY• .. c o <br /> ', `.• o®® .•�� .••� •' i• • •r••••• r- =y_ 1,500 Gallon Scale: 1"=80' <br /> • • .•* : : •••• 'Waite Concrete <br /> 4 `a+ 5��n •••• `,:�,, <br /> on s ..•�\ .J• .. Il Flow Tan <br /> I a a a r•�....• was <br /> '• 1 •0 a <br /> 1st Choice a■ .•.1 t — _ <br /> a Proposed a ■Drain Fi,'d 290'fro • - <br /> I Drain Field ■Northam Property Line�' ' _- 'i� (� <br /> / Replacement. _ <br /> a Area I e <br /> ;'150'of linear Ft. <br /> o :r of EZ House <br /> • r1mn OldBBrO•iiiiiiiitiv <br /> ft, /t <br /> 380'fr&n • ■ <br /> West.r•.i. . 'Tank 385'from t <br /> Property Line ■Northern Property Lineff" a Weil_ 1000— I <br /> 4A.' <br /> 'r• ■: ■ 2000'from East Propert r <br /> rum,.. 1,000 Gallon • <br /> Drab Field •,"Wait"Concrete Tank 1 / • <br /> 17' from w/BioTube Effluent FlAr f <br /> S.,``thorn Future - <br /> P pert Farm Office Tank 125'from \ / • .7r <br /> e Southern Property Line \ ••• <br /> VP <br /> 6 tb■■ © 1S tS-- 1� — - —— - -- <br /> -`'' O 0V 0 <br /> MA <br /> oeg <br /> (show all details and dimensions necessary to locate all components o7the systemn i the fiil°uref d ® ® ® — — F <br /> SYSTEM MATERIALS AND SPECIFICATIONS: INSTALLERS CERTIFICATION: <br /> I HEREBY CERTIFY THAT THE ON-SITE SEWAGE SYSTEM IN- <br /> System Design Sewage Flow Gallons/Day STALLED AT THE ABOVE ADDRESS WAS CONSTRUCTED IN ACCOR- <br /> TANK Size: 1,000 total gallons [X] single compartment DANCE WITH THE REQUIREMENTS OF THE PERMIT AND THE RULES <br /> Manufacturer: Waite Concrete [ ] doable compartmentOF THE ENVIRONMENTAL QUALITY COMMISSION. <br /> Material: Concrete [ ] flow-through IXI I have tested the septic tank and certify it to be watertight. <br /> Effluent Sewer: Header Pipe: The system was installed by: <br /> Size/Mail 4" EZFlow Perforated pipe Size/Mat'l 4"pipe/3034 IX] Property Owner(permittee) <br /> I I Licensed Sewage Disposal Service <br /> DRA1NFIELD rock depth(inches) Box(es) <br /> Rock and under pipe I I Drop IXI Concrete DEQ License Number: - " <br /> / <br /> Pipe total depth__ I I Distribution I I Plastic <br /> EZ Flow Pipe W/peanuts DEQ Certification Number: -/' / / <br /> Drainfield Material(Alternative or pert.pipe) p / <br /> • Total Drainfield Footage 150' Trench Depth Minimum 24" Maximum 30" j <br /> -ice/ <br /> Curtain Drain Depth Signed;/ :� /��— ' <br /> Effluent Pump: Pump Model NA <br /> Pumptimes in <br /> a�/J n< <br /> limes in minutes: on off Gallons per Cycle Company name:_ /� Vff�� tl e <br /> ATT Make and Model (ple e print) <br /> Attach an additional sheet for components and materials not listed above. Date: 1%lb .I <br /> (For Marion County Use Only) The above septic system has been inspected by Marion County. The information has been determined to be accurate <br /> and the system is:VLApproved I I Approved with corrections:' see inspection report I I Denied ( A <br /> 3 <br /> Signed: �� Title: P, t C��� Date: L ` <br />
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