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INDIVIDUAL <br /> (to be completed by system installer) <br /> <br />AS-BUILT PLAN OF CONSTRUCTED SYSTEM: <br /> <br />ON-SITE SEWAGE SYSTEM RECORD <br /> <br /> ~ P~m'r NO. ~' OZ~ <br /> <br />scale: 1" = ~O ' <br /> <br />t <br /> <br />(show all details and dimensions necessary to locate all components of the system in the future) <br /> <br />Septic Tank, Size: <br /> <br />~,~, T--~, Size: <br /> <br />Box(as): [ ] Distri~tion; <br />~e14 P~, Size: <br /> <br />[,(/nrop / ['f/co.:rate; [ ] ma.tic <br /> ; Ma~z~al: Header:~-W~ ; Pert: ~1 <br /> <br />Tz~-~ Deg., Minimum: ~# ; Maximum: ; Curtain Drain Depth: ~ <br />Effluent ~u~, ~ ~el: ~' ~O ; Static H~d in System: ~ ft. <br /> <br /> I ~Y ~TI~ ~T ~ ~-SI~ S~E <br /> <br />~ P~T ~ ~ R~ OF ~ ~IRO~ <br />~I~ ~ISSiON. <br /> [ ] I ~ve test~ the septic t~ ~d ce~ify <br /> it ~o ~ wate~ight. <br /> <br />~e ~tem w~s i~talled ~: <br />[ ]~pe~y ~er (pe~cee) <br />~Lic~ed Sewage Dis~sal Se~ice <br /> <br />(pl~e prOC) <br /> <br /> I[ <br /> (for Marion COunty use only) Il <br /> The above septic system has been inspected by Marion County. The information has been determined <br /> to be accurate and the system is: <br /> ApProved <br /> <br />~s-built. frm 4 WHITE :Marion county; YELLOW: Owner; PINK: I~istaller <br />MC-15-S41 <br /> <br /> <br />