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oGrfln s`1D (- l_x,cys <br /> MARION COUNTY PUBLIC WORKS <br /> BUILDING INSPECTION DIVISION <br /> 5155 Silverton Rd NE/PO Box 14500 <br /> Marion Salem OR 97309-5036 <br /> County (503)588-5147 <br /> www.buildina(Meo.marion.or.us <br /> as-bo3g b—I-1-k)4'? <br /> HOLDING TANK ANNUAL PUMPING RECORD <br /> Facility Name: North Marion Building 1 (Scale house)Permit# <br /> Address: 17827 Whitney Ln NE Woodburn, OR 97071 Date: 2/25/2026 <br /> Inspection <br /> and Alarm <br /> N of <br /> st <br /> Date No.Gallons Licnsed Ultimate Disposal Site Water Usage (confirmed <br /> Pumped Pumper (gal/day) alarm is <br /> working, <br /> yes/no) <br /> 2/24/25 1500 Ace CityOfSalem(COS) Y <br /> 4/1/25 1000 Ace COS Y <br /> 6/25/25 1100 Ace COS Y <br /> 10/6/25 1100 Ace COS Y <br /> 11/25/25 700 Ace COS Y <br /> This report must be postmarked or received on or before January 15, 2026 to qualify for the reduced <br /> Annual Compliance Determination(ACD) Fee of$82.00. ACD fees for reports received after January 15, <br /> 2026 are$240.00. <br /> REMARKS: <br /> I certify that the holding tank has been operated the previous year in full compliance with the permit,and I <br /> am familiar with the information contained in this report and that to the best of my knowledge such <br /> information is true,complete,and accurate. <br /> Name and Title: Andrew Johnson Phone: 503-566-4184 <br /> Email Address: ajohnsonh? �• ion.or.us <br /> Signature: Date: ,`70:S/,G <br />