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CERTIFICATE OF SATISFACTORY COMPLETION <br /> <br /> MARION COUNTY <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />BUILDING INSPECTION DIVISION <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> PHONE: 588-5147 <br /> <br />OWNER: <br />ADDRESS: <br />INSTALLER: <br /> <br /> ON-SiTE SEWAGE SYSTEM INSTALLATION INSPECTION <br />~"I~IP-'¢' ~ SITE NO. ~~ SqE~' <br /> <br />SEPTIC TANK: <br />NO. GALLONS: ..... ! ID(bE::) . <br />MATERIAL: ¢_.4~/~ ¢__ ~ , , <br /> MANUFACTURER: f-~L~'.'.'.'.'.'.'.'.'.~ C_.~&.3 ~___~ <br /> <br />BUILDING SEWER MAT'L: <br />EFFLUENT SEWER MAT'L: <br />COMMENTS: <br /> <br />DISPOSAL FIELD: <br /> TOTAL LENGTH: .. "~ <br /> PiPE MAT'L: <br /> TRENCH DEPTH: <br /> ROCK DEPTH: <br /> DIST. TO WELL:_. <br /> BOXES: <br /> <br />In accordance with Oregon Revised Statute 454.665; this certificate is issued as evidence of satisfactory <br />complet, on of a subsurf~;'~ ~¢~lter~at~.sew.a~isposal~./' / .// ~.,/~/~ ~ system a.t the above location. <br /> INSPECTED BY: ~ ? ~ DATE: <br /> TITLE:--"' ~--' .. <br />MC 15 SO Rev. 12/92 <br /> <br /> <br />