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SIT~ ADDRESS: <br /> <br />INDIVIDUAL ON-SITE SEWAGE SYSTEM RECORD <br /> (to be completed by system installer) <br /> <br />AS-BUILT PLAN OF CONSTRUCTED SYSTEM: <br /> <br />scale: 1" = <br /> <br />North <br /> <br />! <br /> <br />(show all details and dimensions necessary to locate all components of the system in the future) <br /> <br />[ ] Drop / [ ] Concrete; [ ] Plastic <br /> <br /> ; Ma~eri&l: Header: ; Perf:~ <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 />'I I ~ wit~orrections: Date- see znspectlon report,~ ~iL <br /> <br /> <br />