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MARION COUNTY HE ALTH. DEPT. -Sanitation SpecificationSNun ber <br />3-18-69 <br /> ( ~r ai 1 er )~ ~=~-x~- ~=~ ............... <br />~ve3 ~o:: _~ce M. Killin~_~4~g~ ~r~p~r~ A~re~ :~t.~ ~ ~A~svill.e <br /> <br />ScpHc ~nk Minht, um liquidcapacil¥ with distribution box ¢~ Go~s <br />S'ubsurfac~ Disposal F~el~uired ~ Lin ft_. ~_.~__ Width oftr~ncb ...... sq ft ....... <br />Lot survey <br />Other re~uhe~e~tsx r~ ~ ~ ~ ~~~u~d by:: <br /> Record Of Individual Sewage Disposal System <br />To Be Completed by Installer <br /> <br /> · : ~ ~ ,, , 4r ~ ~ <br />INS'IALLERS NAME ' :~ .~.~,_~. ~ ~ ~- Phon~ No ......... Address~::z_.. _ <br />Total number LTving units, / ~ Bedrooms ~ ,Baths ~ Basemenl Yes ~ ~o~-'-- <br />Water supply; Public svstem~ individual woll ~ ~ _Communit~ system <br />ScpHc tank:: Distance from~well~--~~r~! (7 feet, Material__x ' ~' No of c¢¢¢ortments / <br />Tatalliquidcapacity ~,~z) ...... gal Inside length ~ ~ fl inside width ~ ~ .~ft <br /> Diameter 7 ft, LiguJd depth. _~ ~ ..... ft <br />Tde disposal held D~stnbution box? Y~s ~ No ~ Otb~r <br /> <br /> .fi <br /> fi 0istance from:: <br /> ft Well,~ :,-~ <br /> fl Nearest <br /> __It Lot line~ Front[] SideC] <br /> Foundation ~' <br /> Depth benemb e~./'~¢7 .... nches <br />. _ inches Depth of tile below origlnal ground surface ,' -, inches <br /> <br />Total length of all lines ,.," ;"~ ;;.~ <br />Width o~ frcnch -~ '~ <br />Total square footage ~' <br /> <br />Type at filter material Gravel ~,~;d~. ~/',o~ ...... Other <br />Deplb of filler material over liie <br /> <br />iketch of inslollotign <br /> <br />Note indicate Northerly dTrection <br /> ir/spechon will not be made until completed form is returned to the Health Dept <br /> <br />System apparer,tl¢ will [~-'~will not r~ <br /> <br /> ~FO~ HEALTH DEpT USE) <br /> <br />function ~otisfactorily, and is therefore approved <br /> <br />~"'""-' D i so p p r o v o d [] <br /> <br /> <br />