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V,, Marion County Public Works <br /> • ,��I , a�i,,, Building Inspection Division RECEIVE <br /> 5155 Silverton Rd NE <br /> -"'���1 " Salem OR 97305 - <br /> (503)588-5147 Fax(503)588-7948 OCT 0 1 2019 <br /> Mil http://www/co.marion.or.us MA ON COUNTY <br /> BUILDING INSPECTION <br /> ON-SITE SYSTEM MATERIAL LIST <br /> (DIRECTIONS&DEFINITIONS ON BACK) / <br /> ag <br /> Y/ADDRESS c7 lI(l� VI/fy //) id SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS /' yo <br /> p SEPTIC TANK MFG. IN i1 11V CAPACITY /5 ONd MATERIAL40,02&ffie.----- <br /> 0 DOSING TANK MFG. CAPACITY MATERIAL <br /> O SEPTIC/DOSING TANK 0 SINGLE COMPARTMENT 0 TWO COMPARTMENT ❑ FLOW-THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS.INCLUDED <br /> 2. PUMPING ASSEMBLIES <br /> PUMP 1: MFG. MODEL (INCLUDE PERFORMANCE CURVE) ❑ <br /> PUMP 2: MFG. MODEL (INCLUDE PERFORMANCE CURVE) ❑ <br /> h( 'l CONTROL PANEL: MFG. MODEL 0 <br /> v` }{YDROSPLITTER: MFG. MODEL (INCLUDE ORIFICE CALCULATIONS) 0 <br /> EFFLUENT FILTER MFG. MODEL ❑ <br /> DISTRIBUTION VALVE:MFG. MODEL o <br /> 3. EFFLUENT TRANSPORT PIPING il • I l n'I�/ p� <br /> If GRAVITY EFFLUENT SEWER LENGTH I o.5 DIAMETER y MATERIALDU V PIFALL(IN INCHES) lOO <br /> ❑ PRESSURE PIPING: LENGTH DIAMETER MATERIAL PSI <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: & UAL 0 LOOP 0 SERIAL 0 PRESSURIZED <br /> TOTAL LINEAR FOOTAGE: <br /> PRAIN MEDIA: AGRAVEL-LESS ABSORPTION METHOD 0 ROCK&PIPE 0 OTHER e --Z /7ou" <br /> TOTAL DEPTH DEPTH BELOW PIPE `I <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SURFACE): MIN v II MAX 3D <br /> CAPPING FILL DEPTH(DEPTH OF CAP): /, ( �� <br /> f <br /> SETBACKS FROM WELLS: SEPTIC TANK 13` SAND FILTER OR ATT UNIT DRAINFIELD <br /> 5. DEWATERING SYSTEMS(IF REQUIRED) <br /> ❑ CURTAIN DRAIN 0 TILE DEWATERING <br /> �f TRENCH DEPTH: <br /> /v/�PRAIN MEDIA: ❑ROCK&PIPE 0 OTHER <br /> TOTAL DEPTH DEPTH BELOW PIPE 0 FILTER FABRIC <br /> PERFORATED PIPING: DIAMETER MATERIAL ` <br /> 6. ADVANCED TREATMENT UNITS <br /> /l ( 0 SAND FILTER 0 'RGF 0 ATT: TYPE ,,` ..w <br /> G" N-AF <br /> D <br /> a <br /> G:\FORMSISEPTIC\FORMSIS-60 MATERIALS LIST.DOCX Rev 3/18 . <br />