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AUTHORIIATION NOTICE <br />(Supplemental Form) <br /> <br />In order To properly evaluate your existing sa~¢age systeltl~ the follo~ving <br />informstion will be necessary; <br /> <br />rf your sewage system is less than five (5) years old, and wc <br />have an approved racor'd o'f the system, we can proceed without <br />a~y fur=her action on your pert. <br /> <br />If your sewage system is less than five (5) years old, and we <br />do not have a record of an approved installation of the system: <br /> or; <br />If yo[~r ~ewsge System is mor__e than five (5) yesrs old or bas net <br />been pumped within th~? last five years: <br /> <br />a. YOu must have tile septic tank pumped. <br />b. Have the septic tank pumper complete ~he form below. <br />e. A field visit will bu required by ~he $~nitarlan Co <br /> verify the location and .condition of The septic system. <br />d. If you have proof that ~our septic ~ank has been <br /> pumped within CITe last five (5) years, sections a & b <br /> will no: be required. <br /> <br />Rev, <br /> <br />APPROXIMATE SIZE OF SEPTIC TANK: ~--~00 gallons <br /> <br />IS TANK IN GOOD CONDITION? <br /> <br />YES; Ho <br /> <br />ARE BAFFLES OR ELBOWS IN PLACE? <br /> <br />IS DRAINFIELD BACKING UP INTO TANK? <br /> <br /> If yes, explain; ~ <br /> <br />YES; NO <br /> <br />LOCATION OF TANK: <br /> <br />EXAMP LF~ ; <br /> <br /> Septic <br /> Tank <br /> <br />St feet' <br /> <br />5 7~ ? ,:- ~-'5- <br /> <br /> <br />