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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 />SEPTIC TANK: <br /> NO. GALLONS: <br /> MATERIAL:, ..~,~-,~ ~../ <br /> MANUFACTURER: <br /> <br />BUILDING SEWER MAT'L: <br />EFFLUENT SEWER MAT'L: <br />COMMENTS: <br /> <br /> ON-SITE SEWAGE SYSTEM INSTALLATION INSPECTION <br />""'~.g/,,¢-4-.,,~ ~,¢,~.~---,~2 SITE NO. ~ ~/~ <br /> <br /> ~ ~¢/J~ / " PERMIT NO. ¢~/ <br /> <br />DISPOSAL FIELD: <br /> TOTAL LENGTH: <br /> PIPE MAT'L: <br /> TRENCH DEPTH: <br /> ROCK DEPTH: <br /> DIST. TO WEL[~:~~ <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 disposal system at the above location. <br /> INSPECTED B~ A~~L~DATE: <br /> T~TL~.'/-~:.._~/ ~- ~,.~' <br />MC [5-~6 Rev. 12192 <br /> <br /> <br />