Laserfiche WebLink
AUTHORIZATION NOTICE/gXISTING SYSTEM EVALUATION <br /> <br />FORM <br /> <br />In order to properly evaluate your existing sewage <br />following information will be ne0essary: <br /> <br />system, the <br /> <br /> 1. If your sewage system is less than five (~) years old, <br /> and we have a record of t-~ system, we can proceed <br /> without any further action on your part. <br /> <br /> 2. If your sewage system is more than five (5) years old <br /> and/or we do not have a record of the system: <br /> <br /> a. It will be necessary to have the septic tank <br /> pumped <br /> b. Have a DEQ licensed septic tank pumper complete <br /> the form below <br /> c. A field visit 'will be required by the Sanitarian <br /> to verify the location and condition of the septic <br /> system <br /> d. If you have proof that your septic tank has been <br /> pumped within the last five (5) years, sections a <br /> and b above will not be required. Provide <br /> verification of pumping (receipt from pumper) to <br /> this office. <br /> <br /> --FOR SEPTIC TANK PUMPER USE ONLY--. <br /> ,. 2'~ DEQ LICENSE NO: ~/ <br /> <br /> ./~.-L/-,.:z-~--,:-~_ ... ~:C-"'/-. <br />APPROXIMATE SIZE OF SEPTIC TANK: ./, ~,~_0~'~ GALLONS <br />IS TANK IN GOOD CONDITION? ~ NO: <br /> <br />DIAGRAM OE HOUSE AND <br />LOCATION OF TANK: <br /> <br />EXILE: <br /> <br /> J <br /> <br />3/S2 Rev 10/87 <br />car <br /> <br /> <br />