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�,, Marion County Public Works d 3 dd 3aT ?gmr <br /> .ftl�'iiii,,1� BuildingInspection Division - ff \ /� <br /> _ ED <br /> 515 Silverton Rd NE \p, c2 E l� �� <br /> !i `�,. ''''re Salem OR 97305 <br /> 1.11 (503) 588-5147 Fax (503) 588-7948 MAY " I zc: <br /> http://www/co.marion.or.us 4 <br /> MANILA (OUN 1 Y <br /> BUILDING INSPECTION <br /> ON-SITE SYSTEM MATERIAL LIST <br /> (DIRECTIONS&DEFINITIONS,` ON BACK) <br /> ADDRESS 3� / 7 '�s 5/ c 44429/�"i TAX LOT# L/2 L ' C, J o <br /> 54 A4-A I SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS //� <br /> • SEPTIC TANK: MFG. !N,4 t CAPACITY /S` �G ,4 I MATERIAL CO v d c 4e— <br /> • DOSING TANK:MFG. CAPACITY MATERIAL <br /> ❑ SEPTIC/DOSING TANK: 0 SINGLE COMPARTMENT k TWO COMPARTMENT ❑ FLOW-THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS. INCLUDED ❑ <br /> 2. PUMPING ASSEMBLIES <br /> PUMP 1: MFG. 0r'C.w cc, MODEL eF 3OC ✓ (INCLUDE PERFORMANCE CURVE) 0 <br /> PUMP 2: MFG. // MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> CONTROL PANEL: MFG. J�t)k/n t3 Lc S MODEL 7� /,1 /`"//G be- ` ❑ <br /> HYDROSPLITTER: MFG. _ MODEL (INCLUDE ORIFICE CALCULATIONS) 0 <br /> EFFLUENT FILTER: MFG. MODEL 0 <br /> DISTRIBUTION VALVE:MFG. MODEL ❑ <br /> 3. EFFLUENT TRANSPORT PIPING <br /> ❑ GRAVITY EFFLUENT SEWER: LENGTH DIAMETER MATERIAL FA L(IN INCHES) <br /> ❑ PRESSURE PIPING: LENGTH y(J DIAMETER MATERIAL 10lfC:--- PSI V <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: X EQUAL ❑ LOOP ❑ SERIAL ❑ PRESSURIZED <br /> TOTAL LINEAR FOOTAGE: 15-0 <br /> DRAIN MEDIA: ❑GRAVEL-LESS ABSORPTION METHOD ) ROCK&PIPE ❑OTHER/ <br /> TOTAL DEPTH / 2, DEPTH BELOW PIPE 6 <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SURFACE): MIN icy MAX /r <br /> CAPPING FILL DEPTH(DEPTH OF CAP): {- <br /> SETBACKS FROM WELLS: SEPTIC TANK OVPr/66r SAND FILTER ORATT UNIT DRAINFIELD O.L'er MO '— <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 STATE CERTIFIED ff/ <br /> Environmental Health Specialist <br /> PERFORATED PIPING: DIAMETER MATERIAL' <br /> EH-S-10227575‘44.-e,• - ,,-- . <br /> 6. ADVANCED TREATMENT UNITS <br /> ❑ SAND FILTER ❑ RGF ❑ ATT: TYPE <br /> Aldan f3arnmes <br /> G:\BUILDING INSPECTION\FORMS\SEPTIC\FORMS\S-60 MATERIALS LIST.DOCX Rev 3/18 - <br />