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CERTIFICATE OF SATISFACTORY <br /> <br /> BUILDING INSPECTION DIVlSIO'N-..~ <br /> <br /> ~ SALEM, OREGON 9730~ 6 <br /> <br /> / ,ON-SITE SEWAGE, SYSTEM INSTALLATION <br />OWNER: /-/~.¢~4. /Y/, /~*~///~Z¢~y'.~. S~TE NO. <br />ADDRESS: //¢"~¢' '-~"4~'~¢~ ~,)~',.~', ~ <br />INSTALLER: .'?'V'*~_Z.C'~/*~-'"Z~- ~-,¢~,~..,..~',,--~'" ~'~'v'.¢-.- PERMIT NO. <br />SEPTIC TANK: DISPOSAL FIELD: <br /> <br />NO, GALLONS: <br />MATERIAL: ~ <br />MANUFACTURER: <br /> <br />TOTAL LENGTH: <br />Pi PE MAT'L: <br />TRENCH DEPTH: <br />ROCK DEPTH: ..,,,/ <br />DIST. TO WELL:, <br /> <br />BUILDING SEWER MAT'L: ,¢"~ ¢,¢"'¢4/- ~ <br />EFFLUENTSEWE~MAT'L: D'~ 3,~,~/'--~)/'/¢;' .BOXES: <br />COMMENTS: ~/'..~.¢.¢¢¢', ~/-¢,:*-.,~f,~4¢' ~,~ ./-....¢_..~ (2¢,,~ ~. ,¢..~,,~.~.~ <br /> <br />In accordance with Oregon Revised Statute 454.665; this certificate is issued as evidence of satisfactory <br />completion of a subsurface or alternative sewage disDosal system at the above location. <br />INSPECTED BY: ~ ~ DATE: ~,,,~/'2/¢ 5/ <br /> <br /> <br />