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, ON-SITE SEW~.GF_/SYSTEM INSTALLATION INSPEC_I'IOt{r- ?~?.'t~ <br />OWNER: ,,/~_.-/~:4~. ~'//~:~, , , , '" SFFE NO. , ~ 5 <br />ADDRESS: ~ Z ~ ~ 7¢ ~ ~/~, ~, ~ M//~ <br />INSTALLER: ~ ~ ~~: .[ PERMIT NO. <br />SEPTIC TANK: ~ / ' , ~ DISPOSAE FIELD: <br /> NO~ GALLONS; ~ ~ d~ ~, ..~6 TOTAL LENGTH; <br /> MATERIAL: C~~ ' PIPEFUL:' ~"~ <br /> MANUFACTURER; /~ [~ · TRENCH DEPTH: <br /> ROCK DE,H; <br />'BUILDING SEWER ~L: ~ - 5P~-. ~.- , DIST. TO WELL: ~ <br />EFFLUENT SEWER MA~L: ~ ¥~, ~O:~. ~ BOXES: ~ <br /> <br /> / J J <br />In accordance with Oregon Revised Statute 454.665; this cer~ficate is issued ~ evidence <br />completion of a su~udace or al~ative sew~e ~sposal system ~t ~e above location. <br /> <br /> <br />