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AUTHORIZATION'NOTICe/EXISTING SYSTRM EVALUAT~O'N <br /> <br /> PUMPER pOP~M <br /> <br />In order to properly evaluate your existing sewage system, <br /> <br />the following <br /> <br />If your sewage system is less =hah ~ive (5) years old, and we have <br />an approved record of the ~ystem, we can proceed without any <br />further action on your part. <br /> <br />If your sewage system i~ less than five (5) years old, and we do <br />not bare a record of an approved installation of the system: <br /> <br /> or; <br /> <br /> If your sewage system is more than five (5) years old or has not <br /> been pumped within the last five years: <br /> <br /> a. You must have the septic tank pumped. <br /> b. Nave the ~eptic tank pumper complete the form below. <br /> e. A field visit will be required by the Sanitarian to verify <br /> the location and condition of the septic system. <br /> d. if you have proof that your septic tank has been pumped <br /> within the last five (5) years, sections a & b will not be <br /> ~equired. <br /> <br /> Stayton/Mi~ ~y & on <br />COMPANY NAME: Septic Services .DEQ L~CENS~ NO. 34916 <br />PROPERTY OWNER: James C. Strasshofer <br /> , <br /> <br />~J)DRSSS WH~R~ TANK PUMPED: 320 Santiam Avenue, <br /> Detroit ,. Oregon <br /> <br />APPROXIMATE SIZE OF SEPTIC TANK: 300 gallons <br />IS TANK IN GOOD CONDITION? X y~$; NO <br /> <br />~R~ ~AFFLES OR ELBOWS IN PLACE? X ..... YES; ..... NO <br /> <br />IS DRAINFIELD BACKING UP INTO TANK? ..... YES: X NO <br />If yes, explain; <br /> <br />SEPTIC TANK MATERIAL: Concrete__Steel X other ....... <br />Tank has bad lid <br /> <br />DIAGRAM OF BOUSE AND <br />LOCATION OF TANK: <br /> <br />example: <br /> <br />Rev 7/89 pb <br /> <br />RECEIVED <br /> <br />MARION $OUNT¥ <br />iiUILDIN,~ !~P~TION <br /> <br />DATE OF PUMPING: 6/30/92 <br /> <br /> <br />