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AUI%40RI ZATTON NOTICE <br />(Suppl eme~.tal Form) <br /> <br />In order to properly evaluate yonr 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 neceseary to 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 your septic tank has been <br /> pumped within the last five(5) year~ sections'a & b <br /> above will not be required. <br /> <br />i h - For Septic Tank Pumper Use Only - <br />PROPERTY OWNER: C <br /> <br />3/82 <br /> ear <br /> <br />DEQ LICENSE NO: 7"f//c~f~';7 <br /> <br />ADDRESS WNERE TANK PUMPED: <br /> <br />APPROXIMATE SIZE OF SEPTIC TANK: <br /> <br />IS TANK IN GOOD CONDITION? <br /> <br />ARE BAFFLES OR ELBOWS IN PLACE? <br /> <br />DIAGRAM OF HOUSE AND <br /> LOCATION OF TANK: <br /> <br />EXAMPLE: <br /> <br />i~' Sept~¢j tank <br />6' I i ..... <br /> <br /> ~allons <br /> <br />NO <br /> <br />SIGNATURE OF PUMPER: <br /> DATE: <br /> <br /> <br />