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�, Marion County Public Works <br /> ,,II °u,,,„ice Building Inspection Division <br /> 5155 Silverton Rd NE <br /> Salem OR 97305 <br /> IMI (503)588-5147 Fax(503)588-7948 �, <br /> http:/Iwww/co.marion.or.us � _�\�,;I_�' -_ I '1 <br /> ON-SITE SYSTEM MATERIAL LIST <br /> (DIRECTIONS&DEFINITIONS ON BACK) <br /> c <br /> ADDRESS + 4" ; ' '`Vif.1 ,r', r ✓ 1 TAX LOT#07, _\vf13 �'":( :' <br /> SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS / / <br /> ❑ SEPTIC TANK: MFG. „../a I/C'S CAPACITY/ t r` f MATERIAL (2dr"I�f' . <br /> 0 DOSING TANK:MFG. CAPACITY _ MATERIAL <br /> C SEPTIC/DOSING TANK: ❑ SINGLE COMPARTMENT ❑ TWO COMPARTMENT 0 FLOW THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS.INCLUDED 0 <br /> 2. PUMPING ASSEMBLIES <br /> PUMP 1: MFG. MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> PUMP 2: MFG. MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> CONTROL PANEL: MFG. MODEL ❑ <br /> HYDROSPLITTER: MFG. MODEL (INCLUDE ORIFICE CALCULATIONS) 0 <br /> EFFLUENT FILTER: MFG. MODEL 0 <br /> DISTRIBUTION VALVE:MFG. MODEL 0 <br /> 3. EFFLUENT TRANSPORT PIPING <br /> ❑ GRAVITY EFFLUENT SEWER: LENGTH n ER MATERIAL} LL(IN INCHES) <br /> PRESSURE PIPING: LENGTH I _ DIAMETER I /'( MATERIALS C. / PSI <br /> r <br /> 4. DISPOSAL FIELD(DRAINFIELD) /'--- 1 <br /> DISTRIBUTION TECHNIQUE: 0-EQUAL 0 LOOP SERIAL C PRESSURIZED, <br /> TOTAL LINEAR FOOTAGE <br /> DRAIN MEDIA: 0 GRAVEL-LESS ABSORPTION METHOD 0 ROCK&PIPE At OTHER Z 7/4•4f.4,/ <br /> TOTAL DEPTH DEPTH BELOW PIPE '„.-�— <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SUR E);_ MIN / " MAX I.2 t <br /> CAPPING FILL DEPTH(DEPTH OF Pt: /(O _.. - <br /> SETBACKS FROM WELLS: SEPTI 'TANK- . ~-�SAND FILTER OR ATT UNIT DRAINFIELD <br /> 5. DEWATERING SYSTEMS(IF REQUIRED) <br /> ❑ CURTAIN DRAIN ❑ TILE DEWATERING <br /> TRENCH DEPTH: <br /> DRAIN MEDIA: 8 ROCK&PIPE ❑OTHER <br /> TOTAL DEPTH DEPTH BELOW PIPE 0 FILTER FABRIC <br /> PERFORATED PIPING: DIAMETER MATERIAL _ <br /> 6. ADVANCED TREATMENT UNITS STATE CERTIFIED <br /> 0 SAND FILTER 0 RGF 0 ATT: TYPE <br /> Environmental Health Specialist <br /> G:\BUILDING INSPECTION\FORMS\SEP•17C1FORIvIS\S-60 MATERIALS LIST.DOCX Rev 3/18 /4 1*v, EI -S_1 02 40 <br /> Robert Goodwin <br />