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or7,�n 113 \-'t=t7 <br /> t , MARION COUNTY PUBLIC WORKS <br /> "" `'^'" BUILDING INSPECTION DIVISION <br /> 5155 Silverton Rd NE/PO Box 14500 <br /> Marion Salem OR 97309-5036 <br /> County (503)588-5147 <br /> wvvw.buildin9@co.marion.or.us <br /> di+ p-obq°15--101) <br /> HOLDING TANK ANNUAL PUMPING RECORD <br /> Facility Name: Salem Keizer Recycling&Transfer Station Permit# <br /> Address: 3250 Deer Park Dr. SE Salem, OR 97317 Date: 2/25/2026 <br /> Inspection <br /> and Alarm <br /> Name of <br /> st <br /> Date No.Gallons Licensed Ultimate Disposal Site Water Usage (confirmed <br /> Pumped Pumper (gal/clay) alarm is <br /> working, <br /> yes/no) <br /> 1/3/25 2800 Ace CityOfSalem(COS) Y <br /> 3/5/25 2700 Ace COS Y <br /> 7/3/25 2700 Ace COS Y <br /> 9/3/25 2300 Ace COS Y <br /> 11/4/25 2700 Ace COS Y <br /> 12/26/25 3000 Ace COS Y <br /> This report must be postmarked or received on or before January 15, 2026 to qualify for the reduced <br /> Annual Compliance Determination(ACD)Fee of$82.00. ACD fees for reports received after January 15, <br /> 2026 are$240.00. <br /> REMARKS: <br /> I certify that the holding tank has been operated the previous year in full compliance with the permit,and I <br /> am familiar with the information contained in this report and that to the best of my knowledge such <br /> information is true,complete,and accurate. <br /> Name and Title: Andrew Johnson Phone: 503-566-4184 <br /> Email Address: ajohnson@co. arion.or.us <br /> Signature: Date: /af/a,G <br />