Laserfiche WebLink
• <br /> ' MARION COUNTY BUILDING INSPECTION INDIVIDUAL ON-Si'TE SEWAGE SYSTEM RECORD <br /> 155 Silverton Rd NE (to be completed by system installer) <br /> SALEM OR 97305 <br /> 503-588-5147 '51 PERMIT NO. `p`g 0 0 S 2 '/ <br /> MARION <br /> COUNTY :O 6 `�A7S/ , 17 <br /> http:!lwwvvco.marina.orus/PWlSuildinglaspection SITE ADDRESS:ow ,,�{�y+� <br /> AS-BUILT PLAN OF CONSTRUCTED SYSTEM: /Pt G%/C 9 730.5 <br /> Scale:1"=55 ' t <br /> North <br /> "I . - <br /> r. <br /> • <br /> ® - <br /> 7 <br /> • <br /> 1.5 <br /> . ,,, <br /> ' <br /> i- .•.• <br /> —3d=- <br /> T. /olDa <br /> 1 <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 /> I HEREBY CERTIFY THAT-THE ON-SITE SEWAGE SYSTEM IN- <br /> System Design Sewage Flow clSv Gallons/Day <br /> STALLED AT THE ABOVE ADDRESS WAS CONSTRUCTED IN ACCOR- <br /> TANK Size: /$cx-9 total gallons 1 l single compartment DANCE WITH THE REQUIREMENTS OF THE PERMIT AND THE RULES <br /> OF THE ENVIRONMENTAL QUALITY COMMISSION_ <br /> Iulanufacturer: 'l.L.t4r� double compartment <br /> Material: AC [] flow-through 74 have tested the septic tank and certify it to be watertighL <br /> Effluent Sewer:k/ header Pipe: ,,% The system was installed by: <br /> Size/Mat'I I/`i c[.._ 40 Size/Marl '.I 2.?5-9 I 1 Property Owner(permittee) <br /> Licensed Sewage Disposal Service ' <br /> DRAINFIELD I rock depth(inches) Box(es) <br /> • <br /> Rock and under pipe I I Drop [Concrete DEQ License Number: 37043 43 . <br /> Pipe total depth <br /> (Distribution I I Plastic' DEQ Certification Number:ec q/� <br /> Drainfield Material(Alternative orperE pipe) PGe.611 ©w <br /> Total Drainfleld Footage Af1;!7 Trench Depth Minimum 1 Maximun_(2- fs. 1# <br /> Curtain Drain Deptb______ Signed:_ `"" • <br /> Effluent Pump: Pump Model Or SOLOS 30 aPA,` <br /> Pump cycle <br /> times in minutes: on off Gallons per Cycle Company name:JC7' As/ G- <br /> -r-9011/41/41- <br /> ATT Blain and Model �j (please print) <br /> Attach an additional sheet for components and materials not listed above. Date:✓ Z " - <br /> ' r Marion Count/Use Only) The above septic system has been inspected by Marion County. The information has been determined to be accurate <br /> system is: [vj Approved [ I Approved with corrections:see inspection report [ [Denied <br /> • '� Title:\%1-1-55( io233-4'38' Date: 1- I zC/ejj <br />