Laserfiche WebLink
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 /> • 503-5$8-5147 PERMIT NO. . cS 7 74.914 <br /> MARION <br /> COUNTY http://wwwco.marion.or.us/PW/Buiidinginspection ('+ <br /> SITE ADDRESS: /0/7 9 . J�I� �j" tom Sr <br /> AS-BUILT PLAN OF CONSTRUCTED SYSTEM:. j <br /> Scale:In= - t <br /> i <br /> At <br /> 'North <br /> • $ .w4 CD' 'L" PVC- Sc14'4d_ /R ' <br /> ttl` 1`I�. 'w . <br /> �o i Pi f&HAaur 41 vu' 115La°`tt • <br /> ir <br /> 0.0 - -- .my. • if Pvt <br /> RIn <br /> +,,,... r ,z, ,.. ,- ,,,, ..... <br /> , , if' ' L®.�tit , 7® 4- <br /> ,. y$"attct� 4 -d <br /> G. 2'c ��c 41 <br /> y' L_J Zco t,� 8 r t <br /> W t*t <br /> ?PC° /111 tits i <br /> , OOP <br /> 382 1/ s( <br /> e9(1,wr piA�1 <br /> t <br /> (show all details and dimensions necessary to locate all compo ents of the system in the.future) <br /> SYSTEM MATERIALS AM)SPECIFICATIONS: INSTALLERS CERTIFICATION: <br /> S stem DesignSewage Flow I HEREBY CERTIFY THAT THE ON-SITE SEWAGE SYS I hM IN- <br /> y ag VP) Gallons/Day . STALLED AT THE ABOVE ADDRESS WAS CONSTRUC I hD IN ACCOR- <br /> TANK Size: /500 total gallons l ] single compartment DANCE WITH THE REQUIREMENTS OF THE.PERMIT AND THE RULES <br /> Manufactures /q lTC'�` [ J double compartment OF THE ENVIRONMENTAL QUALITY COMMISSION. <br /> Material: C. It' flow-through DC I.have tested the:septic tank and certify it to be watertight.. <br /> Effluent Sewer: i 1 HeaderPipe: , The system was installed by: <br /> Size/Matl plic.3G{d V*3 Size/ivfat'l /Al /VC.. rLHLIO 1 I Property Owner(permittee) <br /> VI Licensed Sewage Disposal Service <br /> DRAINFIELD rock depth(inches) Box(es) <br /> Rock and under pipe 8" I l Drop I I Concrete DEQ License Number: 30 12. <br /> Pipe total depth /2... I I Distribution I I Plastic 12' 7DEQ Certification Number. <br /> Drainfleld Material(Alternative or pert pipe) S'E %Ut.�° ii€ /'!�" fit. <br /> Total Drainfield Footage780.rile reach Depth Minimum 4311 Maximund 81' ,-- <br /> Curtain Drain Depth I 5.6.'A dE t X78' Signed: <br /> Effluent Pump: Pump Model Pc 1 <br /> Pump cycle times in minutes: on off Gallons per Cycle Company name:_ A. cgt o RA'tAJ <br /> (please print) <br /> ATT Make and Modelvr 3 U,if <br /> Attach an additional sheet for components and materials not listed above. Date: 8-2'-21 <br /> (For Marion County se Only)-The above septic system has been inspected by Marion;County.. The information has-been determined to be accurate <br /> and the system is: [ Approved I I Approved with corrections:see inspection report I I Denied <br /> Signed. itle:. ' 'S-T 10`0?3-5j9$' Date: a'1a---J — <br />