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AUTHORIZAT%0N NOTICE <br />(Supplemental Form) <br /> <br />In order to properly evaluate your existing sewage system, the following <br />information will be necessary: <br /> <br />If your sewage system is less than five (5) years old, and we <br />have a record of the system, we can proceed without any further <br />action on your part. <br /> <br />2. If your sewage system is more than five (5) years old or we. <br /> do not have a record of the system: <br /> <br />a. It will be necessary to have the septic tank pumped. <br />b. Have the septic tank pumper complete the for~ 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 your septic tank has been <br /> pumped within the last five(5) years, sections a & b <br /> above will not be required. <br /> <br />car <br /> <br />- For Septic Tank Pumper Use Only <br /> <br />ADDRESS WHERE TANK PUFfPED: <br /> <br />APPIIOXI}~TE SIZE OF SEPTIC TANK: <br /> <br />IS TANK IN GOOD CONDITION? <br /> <br />A~E BAFFLES OR ELBOWS IN PLACE? <br /> <br />DIAGRAM OF HOUSE AND <br /> LOCATION OF TANK: <br /> <br />EXAMPLE: <br /> <br />DATE: <br /> <br /> <br />