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OWNER; <br />ADDRESS: <br />INSTALLER: <br />SEPTIO TANK: <br /> <br />.' ~"'~ "'~ ,,,i',,' .......... '.,., ............ ~. !. <br /> <br />....... ' .......... ~'~"'""~z~ ...................... :' '~'~i'''~''~''' <br /> <br /> __ ON-SITE SEWAGE SYSTEM INSTALLATION INSPECTION <br /> <br /> ?qJ~, ~~ ......... PERMIT NO. P 2 ~ ~ <br /> <br /> / <br />CERTIFICATE OF SATISFACTORY COMPLETION <br /> ' <br /> MARION COUNTY <br /> COMMUNI'I"Y' DEVELOPMENT DEPARTMENT <br /> BUILDING INSPECTION DIVISION ~,. <br /> 220 HIGH STREETNE . ~, | <br /> SALEM, OREGON 97301 <br /> <br /> "::':'":": ~. :: =~ ~" <br /> ;.: .................. ;,4 1 <br /> '~1..2 <br /> <br /> ~ ~'..i .'~ .....'....'!"..i:..."~.~ ..... ':', ..... <br /> <br />DISPOSAL FIELD:. <br /> <br /> NO. GALLONS: /~--~,' TO~FAL LENG'~'H: ....... <br /> MANUFAOTUREI::J: ~~~' T~ENON DEPTH: A ~ / , <br /> ROCK DEPTH: ~/ .... ' ..... <br />BUILDING SEWER MA~L: ~l ~-~ DIST. TO WELL: <br />EFFLUENT SEWE~ MA~L: ~~'~ -.~ B0~S: , , <br /> <br />In ~ccordanoe with Oregon Revised Statute 454.665; this ce~ifl~ate ~s issued as ewdence of satisfactow <br />completion of 8 ~udace or alter~tige sewage di~0sAI system at the above location. <br /> <br />INSPECTED BY~ DATE: <br /> <br /> <br />