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Marion County <br /> <br /> OREGON <br />COMMUNIT~ DEVELOPMENT <br />DEPARTMENT <br /> <br />Building Inspection Division · Community Development Center <br />285 Church 5tree~ NE · Room 132 ° Salem, OR 97301-3670 <br /> <br />SEPTIC TANK A~ANDONMENT <br /> <br /> MARION COUNTY <br />BUll. DIN INSPECTION <br /> <br />THE SEPTIC TANK AT: EMERY & SONS <br /> <br />9694 GOLF CLUB ROAD <br /> <br /> STAYTON OR. 97383 <br /> <br />WAS pUMpED EY: Stayton, Mill City & Silverton Septic Services <br /> (licensed D.E.Q. pumper) 37814 <br /> <br />DATE TANK PUMPED: October 14, 1998 <br /> <br />THE T~K WAS: <br /> [ ] REMOVED <br /> <br /> FILLED <br /> (note: the bottom of the tank should be per- <br /> forated pr cracked to prohibit the accumula- <br /> tion of surface water in.the tank) <br /> <br />FILL MATERIAL: <br /> [ ] REJECT SAND <br /> BAR RUN GRAVEL <br /> CRUSHED ROCK <br /> OTHER: <br /> <br />ENCLOSE A.COPY OF THE <br /> <br />PE ZT #, '07 gA 3 <br /> <br />PUMPING RECEIPT WITH THIS FORM. <br /> <br />SITE #: <br /> <br />abandon.=nk 4/$5 <br />MC-15-S2 <br /> <br /> <br />