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�,,� Marion County Public Works ( , <br /> �'''l� , Building Inspection Division U) c i -.f I !`J`/�1- 1 - <br /> Oil i <br /> 5155 Silverton Rd NE <br /> III ?I ) <br /> %;"--% Salem OR 97305 MAR 16 2021 <br /> MI (503) 588-5147 Fax(503) 588-7948 <br /> http://www/co.marion.or.us MARION COD ,, `Y <br /> 3 JII_.DING INSPECTION <br /> ON-SITE SYSTEM MATERIAL LIST EXP i RED <br /> (DIRECTIONS&DEFINITIONS ON BACK) <br /> ADDRESS !c, c�— (�, Cl1 IK , \n unchaurrn TAX LOT# <br /> SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS ',``� ('� <br /> ❑ SEPTIC TANK: MFG. w� CAPACITY \SOD <br /> €4 I MATERIAL Con <br /> ❑ DOSING TANK:MFG. CAPACITY MATERIAL <br /> ❑ SEPTIC/DOSING TANK: ❑ SINGLE COMPARTMENT ❑ TWO COMPARTMENT ❑ FLOW-THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS. INCLUDED <br /> 2. PUMPING ASSEMBLIES PUMP 1: MFG. o 0C° MODEL W?)00611 (INCLUDE PERFORMANCE CURVE) ❑ <br /> PUMP 2: MFG. MODEL (INCLUDE PERFORMANCE CURVE) ❑ <br /> CONTROL PANEL: MFG. MODEL ❑ <br /> HYDROSPLITTER: MFG. MODEL (INCLUDE ORIFICE CALCULATIONS) ❑ <br /> EFFLUENT FILTER: MFG. MODEL ❑ <br /> DISTRIBUTION VALVE:MFG. MODEL ❑ <br /> 3. EFFLUENT TRANSPORT PIPING <br /> ❑ GRAVITY EFFLUENT SEWER: LENGTH DIAMETER MATERIAL FALL(IN INCHES) <br /> ❑ PRESSURE PIPING: LENGTH DIAMETER MATERIAL PSI <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: ❑ EQUAL ❑ LOOP ❑ SERIAL ❑ PRESSURIZED <br /> TOTAL LINEAR FOOTAGE: <br /> DRAIN MEDIA: ❑GRAVEL-LESS ABSORPTION METHOD ❑ROCK&PIPE ❑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 ❑ TILE DEWATERING <br /> TRENCH DEPTH: <br /> DRAIN MEDIA: ❑ROCK&PIPE ❑OTHER `"`-, <br /> TOTAL DEPTH DEPTH BELOW PIPE ❑ FILTER FABRIC <br /> PERFORATED PIPING: DIAMETER MATERIAL STATE CERTIFIED <br /> Environmental Health Specialist <br /> .0.r. EH-S-1 <br /> •r <br /> 6. ADVANCED TREATMENT UNITS " <br /> ' <br /> ❑ SAND FILTER ❑ RGF ❑ ATT: TYPE \r,' <br /> ) Robert . <br /> G:\FORMS\SEPTIC\FORMS\S-60 MATERIALS LIST.DOCX Rev 3/18 2 1119—.1 <br />