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1. If your sewage system is less than five (5) years old, and we <br /> action on your part. ~ <br /> <br />2. tf your ~ewage system ~,~ i!..or~ than~ffve (5) years old or we <br /> <br />a. IC will be llecessnry to have ~he septic tank pumped. <br />b. Have the septic ~:~;k ,?u'mper complete the ~ot-m below. <br />¢. A field viaiu will he required by the Sanitarian to <br /> veri£y the lock, rich_and cendi=ion of the septic system. <br />d. If you have proof that your Septic tank has been <br /> pumper within the h~st five(5) years, sections a & b <br /> above will no~ be required. <br /> <br />For Septic Tank P~nnpe~ Use Only - <br /> <br />CO}[PANY NA~E: · Stayton SeDtic Service <br />ADDRESS krHERE TANK Pb~rPED: 150 Mackey Lane <br /> <br /> , DetFo,%,~ ore. on <br /> <br />D~Q LICENSE ~o.t~.,,91 <br /> <br />APPROXImaTE SIZE OF SEPTIC TANK: <br /> <br />IS T~NK IN GOOD CONDITION? <br /> <br />ARE BAFFLES OR ELBOWS .IN PLACE? <br /> <br />DIAG~!M OF ROUSE AND <br /> LOCATION OF TAR~: <br /> <br />F35L~fPLE: <br /> <br />Nor th <br /> <br /> gallons <br /> <br />No <br /> <br />NO <br /> <br />~(-NAIUkE OF PU}~ER: <br /> <br /> -' 9/;:'6. 8~" <br /> <br /> <br />