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0 <br /> Public CountyPub Ic Works <br /> ,III 12i„ Building Inspection Division <br /> {-- _ 5155 Silverton Rd NE <br /> Salem OR 97305 <br /> (503)588-5147. Fax(503)588-7948 <br /> http://www/co.marion.or.us • <br /> ON-SITE SYSTEM MATERIAL LIST <br /> (DIRECTIONS&DEFINITIONS ON BACK) <br /> ADDRESS /2 5 0 8 ir/-AN e/ 5!0tt5 Ad TAX LOT# • <br /> 9 5 eofa*a /y,l�s o�, <br /> SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS VA <br /> ❑ SEPTIC TANK: MFG. SIG CAPACITY 10 OO a/ MATERIAL CO K C r e f e. <br /> • DOSING TANK MFG. CAPACITY MATERIAL <br /> ❑ SEPTIC/DOSING TANK: 0 SINGLE COMPARTMENT 0 TWO COMPARTMENT 0 FLOW-THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS.INCLUDED ❑ <br /> 2. PUMPING ASSEMBLIES <br /> PUMP 1: MFG. MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> PUMP 2: MFG. MODEL (INCLUDE PERFORMANCE CURVE) ❑ <br /> CONTROL PANEL: MFG. MODEL 0 <br /> HYDROSPLITTER MFG. MODEL (INCLUDE ORIFICE CALCULATIONS) ❑ <br /> EFFLUENT FILTER: MFG. MODEL ❑ <br /> DISTRIBUTION VALVE:MFG. MODEL ❑ <br /> 3. EFFLUENT TRANSPORT PIPING <br /> if/GRAVITY EFFLUENT SEWER: L LENGTH /6 DIAMETER 4 �� MATERIAL 3b 3 yFALL(IN INCHES) <br /> ❑ PRESSURE PIPING: LENGTH DIAMETER MATERIAL PSI <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: D EQUAL ❑ LOOP IcSERIAL 0 PRESSURIZED <br /> TOTAL LINEAR FOOTAGE: 3 7 .Jr DRAIN MEDIA: ❑GRAVEL-LESS ABSORPTION METHOD 0 ROCK&PIPE ❑OTHER E C Z f i D vww <br /> TOTAL DEPTH .2 Y DEPTH BELOW PIPE 10 <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SURFACE): MIN MAX 3 L 1' <br /> CAPPING FILL DEPTH(DEPTH OF CAP): • <br /> SETBACKS FROM WELLS: SEPTIC TANK - SAND FILTER OR ATT UNIT DRAINFIELD J. . 0 <br /> 5. DEWATERING SYSTEMS(IF REQUIRED) <br /> C CURTAIN DRAIN ❑ TILE DEWATERING <br /> TRENCH DEPTH: <br /> DRAIN MEDIA: ❑ROCK&PIPE ❑OTHER STATE CERTIFIED TOTAL DEPTH DEPTH BELOW PIPE ❑ FILTER FABRIC <br /> Environmental Health gpec,a i <br /> PERFORATED PIPING: DIAMETER MATERIAL EH-S-1 C227575 :+" <br /> N' .f <br /> 6. ADVANCED TREATMENT UNITS <br /> ❑ SAND ALTER ❑ RGF 0 KIT: TYPE " ------ <br /> a Aldan• <br /> G:IBUILDING INSPECTION\FORMSVSEPTICWORMSIS-60 MATERIALS LIST.DOCX Rev 3/18 <br />