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Marion County <br /> <br /> OREGON <br />COMMUNITY DEVELOPMENT <br />DEPARTMENT <br /> <br />Building Inspection Division · Community Development Center <br />285 Church StreetNE · Room 132 · Salem, OR 97301-3670 <br /> <br />SEPTIC TANK ABANDONMENT <br /> <br />THE SEPTIC TANK AT: <br /> <br />Gary and Kathy Hales <br /> <br />11535 McClellan Lane <br /> <br />Aumsville OR 97325 <br /> <br />WAS PUMPED BY: Stay,on, Mill City and Silverton Septic Services <br /> (licensed D.E.Q. pumper) ~ 37814 <br /> <br />DATE TANK PUMPED: <br /> <br />05/26/99 <br /> <br />THE TANK WAS: <br /> [X] REMOVED <br /> <br />[] <br /> <br />FILLED <br />(note: the bottom of the tank should be per- <br />forated or cracked to prohibit the accumula- <br />tion of surface water in the tank) <br /> <br />FILL <br /> <br />MATERIAL: <br /> [ ] REJECT SAND <br /> [ ] BAR RUN GRAVEL <br /> [ ] CRUSHED ROCK <br /> [ ] OTHER: <br /> <br />ENCLOSE A COPY OF THE PUMPING RECEIPT WITH THIS FORM. <br /> <br />PERMIT #: <br />SITE #: <br /> <br />abandon.tnk 4/95 <br />MC-15-S2 <br /> <br /> <br />