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I <br /> • <br /> • <br /> MARION COUNTY BUILDING INSPECTION INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> dim 5155 StIveston Rd NE J (to be completed by system installer) <br /> 503-588-5147 � PERMIT NO.SS-"`2"! ' a,/68 - Pr)/I T <br /> MAfION <br /> COUNTY bitpd/www.carnerinn.nrJa/PW/HuildingInapection SITE ADDRESS: 1,LG) Li_7 try ,..rt71 <br /> AS-BUILT PLAN <br /> OFC_ONSTRUCTED SYSTEM; Sri j C <br /> Scale:I"=4T <br /> 4 <br /> +02 <br /> I i01 thirst <br /> c s',1e' 4-6 Z37 1 <br /> 4 ot {; G r8 ; <br /> t i % - p = 2ci <br /> Vt heat 7 , ?�+- l+j , <br /> sccla • vs_wri: - + <br /> •...._ <br /> if' i' lI` Q r 33 %So4 <br /> I3os 1 li 7r' S <br /> kfui 4w ` <br /> 3cak <br /> (show all details and dimensions necessary to locate all coca•wants of the system in the future) . <br /> SYSTEM MATERIALS AND SPECIFICATIONS: INSTALLERS CERTIFICATION: <br /> SYSTEM IN- <br /> Sritam Design Sewage Flow`!SO Gallons/Day STALLED I HEREBYAT THE MOVE ADDRESS WAS CORTIFY THAT THE ON-SITEANSTRUCTED IN ACCOR- <br /> TANK Sire f i St)Q total gallons EA single ounpanmani DANCE WITH 71dE REQUIREMENTS OF THE PERMIT AND THE RULES <br /> MannftutureS 4 t�. t [)double cmt+parta+cm OF THE ENVIRONMENTAL QUALITY COMMISSION. <br /> Mlateriak Galt r t. . • I I flow-duou4t III have tested the septic tank and certify it to be watertight. <br /> Musa Sewer. rt Header Pipe: The The system Was installed by; <br /> S;a/Mat'i 1.f it 1h Sjze/Mat'1 4 Sax iu I IProperty Owner(penuluee) <br /> 14 Licensed Sewage Disposal Service <br /> DRAINFIELD rock depth(inches) Bold* / <br /> Rock and under pipe I I Drop I I Concrete DEQ License Number:�°6'4/C! <br /> PIpe total depth I Distribution I I Plastic �j <br /> De st DEQ Certification Number: rJ <br /> Malachi Material(Alternative as pert pipe} FZ•14 Ow . <br /> Total Drainlldd Footage 14'S0 Trench Depth Minimum...ILI Maximum 9.6 Carlain Drain Depth. Signed: ...eat- H A v f/ <br /> ' <br /> EIAueetPump:Pump Model NI"- . <br /> Pump cycle �j / / / t <br /> times in minutes:on off Gallons per Cycle Ce Company name: M di l et.,.1r�' oh 4 <br /> ATT Make and Medal 04444 4eR e ) <br /> Attach art additional dial far romponenta and materials not gatedAmt. Dale: `�j 1I <br /> }For Marion Counts a Only) The above septic system has been inspected by Marion County. The information has been determined to be accurate <br /> and the system is: IApproved I I Approved with corrections:see n //�inspection spectionn$report I I Denied <br /> Signed - 1-Title: _1O 1223 Date: `"y("fl/ � <br /> MC:S-41 rev:3/03;Ni2;5/14;11/17 G:Womn\Septio1S-41 As-DuilUAI5Verslon2017.doe ' WHITSbfWkur Cuero:YELLOW.•Owner;PINK:Wsralkr <br />