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CERTIFICATE OF SATISFA~Y COMP~ETiONL.. <br /> COMMUNI~ DEVELOPMENT DEP~TMENT ~ [ ~ <br /> BUILDING INSPECTION DIVISION ~ ~~ <br /> <br />SALEM, OREGON 97301 <br />PHONE: 588-5147 '- ..... - <br /> <br /> /,ON-SITE, SEW~AGE SYSTEM INSTALLATION INSPECTION <br />OWNER: ~/--~3,.-/4.~,~¢~ .~r.~.~.~ SITE NO;,~ ~V'- <br />ADDRESS: ~ ~b'~/~ ~. ~~ ~ ' <br />INSTALLER: ~ ~~~ PERMITNO. <br />SEPTIC TANK: <br /> NO. GALLONS: /~¢¢,~/ ~¢~¢~¢ DISPOSAL FIELD: <br /> TOTAL LENGTH: / <br /> MATERIAL: ~ ~ ~ ¢ PiPE MAT'L: ~- ~ 7 ~ -~ <br /> MANUFACTURER: ~ ~ TRENCH DEPTH: <br /> _ ROCK DEPTH: ~'~ <br />~UiLO~N~ SEWER MAT L: ~- ~ 3 ¢-- ~¢¢ , . e~ST. TO W~LL:~¢ ~'~~¢¢. <br /> EFFLUENT SEWE~ MAT'L: ~ ~, .~ ~ ¢~ ~¢¢¢~.~./¢ BOXES: <br /> <br /> ~~~, . ,, , , <br />In accordance ~ Oregon ~evised Statute 454.665; this certificate ~s issued as evidence of sat~sfac~ <br />completion of a subsud8ce or 6lte~ative ~wage disposal system 8t the above location. <br /> <br />MC 15-86 Rev. 12~2 <br /> <br /> <br />