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Subsurface D'ispos,_~t-. ~.¢i,,d required. // .~c__'~,' .Lin. ft, <br />Lot survey_ ~? ~/'; <br /> ~-. <br />Other <br /> <br /> MARION COUNTY .)DEPT. -Sanitation SpecificationS umb r ..... <br />.etmil Issued To;. ,~.~~ Property AdOress~~ <br /> <br />SepH¢:,~onk: '~inlmum liquid copacily with distribution box ~ ~/ Gals. ~ ., <br /> ~t, Width oftrench .sq, ft <br /> <br /> Record Of IndiVidual Sewage Disposal System <br />To Be Completed by Installer '" <br /> <br />INSTALLERS NAME <br />[oral number: Living unit~ <br />Water supply: Public system ...... <br />Septic tank: Distance ~?om well <br />Tolal hquid capacity. <br /> Diameter <br />Tile disposal field: Distribution box? <br />Lerl~th of each line .... <br /> <br /> Phone No '__Address, <br /> Bedroom~ Baths Basemenh Yes [] No [] <br /> Individual well. __ Community system <br /> __ feet. Malerial No. of compartments <br /> gal, Inside length .ft, inside width. .fl. <br />~__ft. Liquid depth .ft. <br /> Yes [] No [] Other <br /> <br />ft. <br /> <br />Total length of all lines <br />Width of trench <br />Total square footage <br /> <br />Distance between lines· <br /> <br />Type of filter materlah Gravel: <br />Depth of filter material over tile <br /> <br />Sketch of installation, <br /> <br />ft, Distance from: <br />__ ft. Well __.ft, <br />__ ft. Nearest <br />ft. Lot llne: ~ront [_~_ Side [] Rear [] ft, <br /> Foundation .it, <br /> ~_~Other , , Depth beneath tile __inches, <br /> inches. Depth of tile below original ground surface inches <br /> <br />Indicate Northerly diitectica(. <br />Inspect/on will not b,& mc~te until c9mpleted form is returned to the Heohh. Deph <br /> <br />DATE <br /> <br />Signatur~ of Installer <br /> <br />System apparently will ~ill not ~] <br />Remarks. <br /> <br /> (FOR HEALTH DI[I:~'. USE) <br /> <br />function satisfactorily, and is therefore approved <br /> <br />Copies': (1) OriEl, HD Files <br /> <br />MARION <br /> <br /> <br />