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t <br /> <br /> , ON.SITE SEWAGF~SYSTEM INSTALLATION INSPEC~TIO[~ <br />OWNER: /~: ~//~, SITE NO. t._ <br />ADDRESS:iNSTALLER: ;',~/~ ~p~ ~,~,~ ~PERMITNO. <br />SEPTIC TANK: ' ~ ~ ' DISPOSAL FI~ <br />NO. GALLONS: /.~/. ~f'-, ~/ ~z~ TOTAL LENGTH: <br />MATERIAL: C~ ~ ~ PiPE MAT'L: <br />MANUFACTURER: /~ /~ ~ TRENCH DEPTH: <br /> ROCK DEPTH: <br />BUILDING SEWER MAT'L: ~ - ~P~¢.- ~¢~-. DIST. TO W~LL: <br />EFFLUENT SEWER MAT'L: ~ "~.~ '~¢¢~ ~ BOXES: <br />COMMENTS: -- <br /> <br /> / .1" . <br /> <br />In accordance with Oregon Revised Statute 454.665; this certificate is issued as evidence of satisfactory <br />completion of a subsurface or alter~.at~ve sewage disposal system at the above IoFabom <br /> <br /> TiTLE:~L~,~.~./'.~/~,~¢,.~.~ f / / <br />MC 15-S6 Rev. 12/92 <br /> <br /> <br />