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AUTHORIZATION NOTICE <br /> (Supplemental Form) <br /> <br />In order to properly evaluate your existing sewage system, the following <br />information will be necessar~ <br /> <br />rf your sewage system ie lees than five (5) gears old, and we <br />have an approved record of the system, we can proceed without <br />any further action on your part. <br /> <br />If your sewage system is lees than five (5) years old, and we <br />do not have a record of an approved installation of the system: <br /> er; <br />If your sewage system is more than five ($) years old Or has not <br />been pumped within the last five years: <br /> <br />a. You must have the septic tank pumped. <br />b. Have the septic tank pumper complete the form below. <br />c. A field visit will be required by the Sanitarian to <br /> verify the location and condition of the septic system. <br />d. If you have proof that pour septic tank has been <br /> pumped within the last five (5) years, eections e & b <br /> will not be required. <br /> <br /> -For Septic Tank Pumper Ue~ Only- <br /> <br />~PROXIMATE SIZE OF S~PTIC TANK: ......... gallons <br />IS T~K IN GOOD CONDITION? ~ YES; NO <br />ARE BAFFLES OR ELBOWS IN PLACE? ~YES; NO <br />IS D~INFIELD BACKING UP INTO T~K? ~YES; NO <br /> <br /> NN~IPLE <br /> <br /> SIC~ATUR~ OF PUMPER~_ <br /> <br /> <br />