Laserfiche WebLink
' CERTIFICATE OF SATI COMPLETION <br /> <br />COMM[J F DEPARTMENT <br /> BUILDING IVISION. <br /> 220 H[~ <br /> SALEM, <br /> PHONE: 588-5147 <br /> <br />OWNER: <br />ADDRESS: <br />INSTALLER: <br />SEPTIC TANK: <br /> NO. GALLONS: ~.~,~,,~.., ¢.,,,,~,~ <br /> NUFACTURER.. ~.~ ,,, <br /> <br />BUILDING SEWER MAT'L: DIST, TO WELL: <br /> <br />in a~ccordance with or'egon Revised Statute 454.665; this oertifica, te is i~sued as evidence of satisfactory <br />completion of a subsurface or 81~rnative sewage disposal system at the above location. <br /> <br />..~/f, ON-SITE SEWAGE SYSTEM INSTALLATION INS/P~CTION 7'" · ~,~-'//_~ ~ ~~ .,SITE NO. <br /> ........... <br /> ~~~" , '~ PERMITNO. <br /> DISPOSAL FIELD: <br /> TOTAL LENGTH: <br /> PIPE MAT'L: <br /> TRENCH DEPTH: <br /> ROCK DEPTH: <br /> <br /> <br />