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MA.RION Cio—o-rY BATILDTh GL';tSPECTIO`t ;virmi!DLAL AN-sraSEW tGE i T ' C6 •
<br /> SIS v tt i Rd E (to b to pteted,b system IHS: ,.I-
<br /> SAL,E 1 OR 9736
<br /> OUIPTY
<br /> Itt• 4.1,,,iny x�ran ion,or uts{PWJButldingtsspeettorn SITE ADDRESS, CI ' g7,,,,,,._..._..,_____,,,.,___.,,,,....,,..,:.
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<br /> 3UILT 'LOR' Oi+PST"13LiCTE'D.SY SfiEl3: , .
<br /> North:
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<br /> yam+ {s/�'J� ,
<br /> (C(41)' .
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<br /> ' (show all details and'dimensions.necessary to locate all'components of thesystem in the future)
<br /> SYSTEM MATERIALS AND`SPECIFICATIONS` INSfAI:LERS CERTIFICATION
<br /> ' I HEREBY CER THATT E ON-SITESEWA IN�
<br /> T- : • Gfi•SY5T1~►3 €
<br /> System Design Sewage Flory ' GallonslDay . STALLED ATTHE ABOVE ADDRESS WA 'CONSTR.UUGTED.N ACCOR.
<br /> tz
<br /> TANKSize C)C) total gallons ('] single.compartment a DANCE WITH;THE REQUIREMENTS OF THE PERMIT AND THE RULES;
<br /> f� [,) doubiecompartment OF.THEENVIRONMENTALQUr1LTTYCOMMISSION
<br /> flaw-through • a septic
<br /> Material . �'.b,:� ve tested th
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<br /> �I ha tank and ceztify it•to be watetttgiit.
<br /> Eifuent Sewer::1/�}s fj`����('� , Header Pipe sy� was installed by
<br /> Siz uen t S `f' 1J"u Sizelttilat I E'er S f'71-� �Y der(perinttt ial +.. ''
<br /> x 1 1 Licensed Sewage Disposal Service
<br /> D12INFIELD I. tarp depth(inches) Eo:(es2 _ -�
<br /> l =x Concrete License Number:::',.. .,$ 3
<br /> ' :.`I Rock and ': ,: ,Pe l roP DE
<br /> Pipe: totaldepth . 11 Distribution - 1.1 Plastic
<br /> DEQ Certification mbar
<br /> .Dtarn$etd Material(Alteinnave.or pert pipe) vet,
<br /> Total Dr?intleld Footage Trenehr Depth Mruimunt Maximum:
<br /> :Curtain Drain Depth " '. 15
<br /> Signed /.".,.,--
<br /> ;:EfliuentPump,Pump Model'
<br /> tX � ��
<br /> Pump cycle 11 M ,... �� C aYt'aFf U"t tt ". .-
<br /> nines m mwutcs on ' - off r Gallons pei Cycle Company nal..„,, 7Gv "r7 ti-S:,--l-4 C
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<br /> q4 (please,print)
<br /> ATT Make and Model
<br /> l Attacb`an:additfonal sheet for'co orients and materlals not'listed'ahnve.. . - Date .�.ZS
<br /> '(l+orr Marion County Use Only)"The aboveseptic system has;been inspected-by Marion County The information has been determined to be accurate 1
<br /> and the system is:;[']Approved ( j Approved with orr cections:•see•inspection'report ., ,; '[ i Denied
<br /> •
<br /> Signed Title ,. ;; Dates
<br /> MC,S-41 ro r 3103�t4I12,5114;.11/17 ' lFarrn3LSrphcti.S�t1 Built2015Vetalon20l7.dcc IYNITIr.htarion'Cnnnuy;YELLOW Owner;PINUn.rtaller. ,
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