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~ INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> ~ (to be completed by system installer) <br /> <br />AC-BUILT P~ OF CONSTRUCTED SYST~: <br /> scale: 1" = ~O ' <br /> <br />· ,95 <br /> <br />(show all details and <br /> <br />-II- <br /> <br />necessary to locate all components of the system in the <br /> <br />~(e~}: ~] Dis~ributi,o,n; [ ] Drop / ~ Concrete; [ ] Plastic <br /> <br />The system was installed ~f: <br />Property Owner (permitee~ <br />Licensed Sewage Disposal Service <br /> <br />Pump Cycle Time: ~/ ; Gallons per ~cle: <br /> <br /> (for Marion County use only) <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 />[ ] Approved~-l~h/~or~c~ns: s~ inspection report <br />[ ] ~enied ~/i/ II I1~ ~ ~ ~ . ~- .-? <br /> <br />~s-built.frm 4/95 WHITE:Marion County; YELLOW:Owner; PINK:Installer <br /> <br /> <br />