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oilMARION COUNTY BUILDING INSPECTION INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> 5155 Silverton Rd NE (to be completed by system installer) <br /> Salem,OR 97305 <br /> 503-588-5147 PERMIT NO.555-24-006295-PRMT <br /> MARION <br /> COUNTY http://www.co.marion.or.us/PW/BuildingInspection <br /> SITE ADDRESS: 49850 N Santiam Hwy SE <br /> Idanha,Oregon,97350 <br /> AS-BUILT PLAN OF CONSTRUCTED SYSTEM: <br /> Scale:1"= ' <br /> North <br /> • <br /> See Attached <br /> • <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 /> System Design Sewage Flow 300 Gallons/Day I HEREBY CERTIFY THAT THE ON-SITE SEWAGE SYSTEM IN- <br /> STALLED AT THE ABOVE ADDRESS WAS CONSTRUCTED IN ACCOR- <br /> Septic Tank:Size loon gallons Mall Plastic Mfg Infiltrator DANCE WITH THE REQUIREMENTS OF THE PERMIT AND THE RULES <br /> OF THE ENVIRONMENTAL QUALITY COMMISSION. <br /> Dosing Tank:Size •gallons Mall Mfg <br /> [}]I have tested the septic tank and certify it to be watertight. <br /> ATT Make and Model Box(es): <br /> [ ]Distribution The system was installed by: <br /> Effluent Sewer:Size a- Mall PVC [ ]Drop <br /> [ ]Property Owner(permittee) <br /> Existing [)]Concrete <br /> Drainfield Pipe:Size Fxiat [ ]Plastic <br /> Pc]Licensed Sewage Disposal Service <br /> Material:Header Pipe Perforated Pipe_ DEQ License Number: 38988 <br /> Total Drainfield Footage Trench Depth Minimum_ Maximum_ DEQ Certification Number: RI 792 <br /> Rock Depth:Total Under Pipe Curtain Drain Depth <br /> Signed i^ � <br /> Alternative Drainfield Materials <br /> Effluent Pump: Pump Model • Company name: New Creation Contracting <br /> Pump Cycle minutes minutes (please print) <br /> Time on off Gallons per Cycle <br /> Attach an additional sheet for components and materials not listed above. Date: 8/18/24 <br /> (For Marion County Use Only) <br /> Thebve septic system has been inspected by Marion County.The information has been determined to be accurate and the system is: <br /> [' Approved [ ]Approved with corrections:see inspection report..,��r[ ]Denied <br /> Signed: i Title: 10Z53J ? Date:6160/Zq <br /> MC:S-41 rev:3/03; /12;5/14 WHITE:Marion County;YELLOW:Owner;PINK:Insraller <br />