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Marion County' <br /> OREGON <br /> COMMUNITY DEVELOPMENT <br /> DEPARTMENT <br /> <br />Buildin§ Inspection Division · Community Development Center <br />285 Church Street NE · Room 132 · Salem, OR 97301-36?0 <br /> <br />RECEIVED <br /> <br /> NnV 0.~ 1999 ur] <br />MARION COUNTY <br />BUILDING INSPECTION <br /> <br />SEPTIC TA/~K ABA/~DONMENT <br /> <br />THE TANK WAS: <br /> ~] 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 h;ate~in the_~]<) _ ..... <br /> <br />FILL <br /> <br />MATERIAL: <br />[ ] REJECT SA/~D <br />[ ] BAR RUN GRAVEL <br />[ ] CRUSHED ROCK <br />[ ] OTHER: <br /> <br />ENCLOSE A COPY OF THE PUMPING RECEIPT WITH THIS FORM. <br /> <br />SITE #: <br /> <br />SIGNED: <br />PE~IT #: gq~O~Igc) <br /> <br />abandon. :nk 4/95 <br />MC-1S-S2 <br /> <br /> <br />