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• <br /> • <br /> MARION COUNTY BUILDING INSPECTION INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> 5155 Silverton Rd.NE (to be completed by system installer) <br /> SA5 3IEM-88-04 97305 7 PERMIT NO. � '� 0 � <br /> MARION COUNTY SITE ADDRESS: egarMg.p) fG—QY� <br /> htt •//www.co.marion.or.us/PW/Buildin Ins ection <br /> AS-BUILT PLAN OF CONSTRUCTED SYSTEM: ef'f At/14 19g /. 7 :7 <br /> Scale:1"= T <br /> North <br /> tij b.- <br /> it <br /> Ie" <br /> A.414-1? <br /> 545: - <br /> (show all details and dimensions necessary to locate all components of the system in the future) <br /> SYSTEM MATERIALS AND SPECIFICATIONS: INSTALLERS CERTIFICATION: <br /> ON-SITEZOO I FIEREBY CERTIFY THAT THE <br /> System Design Sewage Flow tiallonslDay ;•VE ADDRESS WAS CONSTRUCTED IN ACCOR- <br /> TANK Size: I t OO total gallons single compartment DANCE WITH THE REQUIREMENTSOF THE PERMIT AND <br /> THE RULES <br /> Manufacturer: 611a1 .�L• I double compartment OF THE ENVIRONMENTAL QUALITY COMMISSION. <br /> :I flow-through / <br /> Material: ��GP�� watertight. <br /> Effluent Sewer: t/ Pife ru,1 a header Pipe:pm tl n cinstalled <br /> Size/Mat'1 Y PTV Y Size/Marl y 450.3 . 1 I Property <br /> — INlicensed Sewage Disposal Service <br /> DRAINFIELD rock depth(inches) aox(es) - <br /> Rock and under pipe '`- ' prop r}d'Concrete • Number: <br /> Pipe total depth I I Distribution <br /> ,J I I Plastic •Certification r <br /> Drainfield Material(A ltemativeorperf.pipe) Z F2 PA !, <br /> Total Drainfield Footage �e5O Trench Depth Minimumdi Maximum- <br /> Curtain Drain Depth p? "tom''' <br /> Effluent Pump: Pump Model /W is L . <br /> Pump cycle <br /> times in minutes: on T''''-''' off ' Gallons per Cycle _ Company <br /> ATT Make and Model .-•1'"- (please print) <br /> Attach an additional sheet for components and materials not listed above. Date: <br /> (For Marion County a Only) The above septic system has been inspected by Marion County. "1 e information has been determined to be accurate <br /> and the system is: 114 Approved I I Approved with corrections:see inspection report 1 1 Denied <br /> Signed: Title: EU-s T I O.Z33 Date: 1/)5/ZLI <br /> MC:S-41 rev;3/03;4/12;5/14;11/17 G:;Forms'•.SeptietS-41 As-Built2015 Vers i on 201 7.doc WHITE:Marion County; YELLOW:Owner;PINK:Installer <br />