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frmill 130aMNaMrsrrauaauacu 'scnav ------ <br /> - _....Tto bar Completed b'y system instailer- <br /> DnrtsioN <br /> MhnION I. $SS COIXSiREIPOBox(4500 <br /> COUNTY moa sa )q33 V S;E. 5,p a Kin_ & KA.. <br /> . (w3)smste SITE ADDRESS: <br /> -.4tPERMIT NO: 03- Y <br /> !.9-AUZLT•PLAN OP CONSTRUCTED SYSTEM: <br /> • <br /> scale: l" = ' i <br /> Az A eX i i rtSZY Pte.:m. tries • North <br /> 5J11I c r, +mss;. 1.6►• . <br /> 6- Po' y"3a)3 y,Ta;1pc�. exist'. MA 6aN' <br /> C = 'No.1Dish 00,144: w i14t.+nrhitiea+. .i:, c <br /> Ds. 30' A i;4iaruk\ tko%1S;1t\• • .II , ,-S '404‘ •► ` <br /> . MIAiPMS OA.C• 10tV4.1. 6. <br /> F " <br /> esT <br /> € 7 /25 ► • `-• '4 • <br /> • l <br /> • GoIiLT <br /> ' // iwWI.0 <br /> • <br /> - •4• - C.NiSsit jig. miaow <br /> few 4Ftc-t.4) Gr itt. ..69. <br /> Its c;,-LQ: cri4...1....--• _ . <br /> (show all details and dimensions necessa to locate all c.•..onents of t s stem in the future -; <br /> Mani uttravirigtro sssaWMATtoNBt Ii'IStTlttjl¢AS s:anrlMXCATI'M. ' <br /> Spates:peek:a nom '"-0 Gallons/My I HEREBY CERTIFY THAT THE ON-SITS SEWS <br /> BeptlO TWO Size: .Tt1st'1i SYSTEM INSTALLED AT TREMOR ADDRESS WAS CON- <br /> N1G, I4fgs, 7 7 STRUCTED IN ACCORDANCE WITH TOE REQUIREMENTS OF <br /> 12143". <br /> THE PERIQT A1ND THE RULBB OP TRE ENVIROS>MEFTTALnosing Tanks SizesNat'l: _ Mfg:, <br /> 4URLITY CO.YND[SSION. <br /> t ) I have tested the septic tank and certify <br /> - affluent 5901111 .91:30:: y• Nat'l: •' � r it to be watertight. <br /> aox(q): D3sbr.mutioa�s 1 3 Drop / L�j C arota: [YJ piasti�c The�� �syo�sepe��m installed by:y . • <br /> Dreiufi ld tipes Sire: / 1 fbttfrie7.:G�:�'=1 0 s PbrEs P414) [�Liceased sewage 6iopat+�.��t' Serv+icco <br /> Total DraiaEieId lootegss 7 Rook Depths Total:, r Under pipe:A._ . DEQ License Number: , �7y!70 <br /> Alternative trea4+'fi ld Datariales �"'"'"'""'' .ter'' <br /> a• EiffatIlliii1;:" ' <br /> Trench Depths idi.aitaemr ly 8p ,1 llazienmi:eLff 1 Curtain LrAia DeDth:,pi'' �j <br /> Effluent Peet Pump Model: J Static Read in System: "---.• rt. Company name: 11 a. v.Ti ., <br /> Pump Cycle Time: ; Gallons per Cycles (please print - <br /> bate: -21*-d3 <br /> Attach an additional sheet for camomenta and si atarleas not.listed abrnr 4,,,, r,,K <br /> (for Marion County us* only) <br /> • <br /> The above septic system has been inspected by 3e rioai County. The information has been determined to be accurate and <br /> t2All system is: <br /> APP <br /> l Ap. '. ed w .. c•, tions: see inspection report <br /> Signed: Si■ :• 1 1 :A — Title:, err+ Date: 0 <br /> - " '- -_. _ - <br /> MC: S-41 WRITE:Marion County; YELLOW:Owner; •INKainsta ler <br /> rev: 8/00,6/01 <br />