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In order to ~roperly evaluate your 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 have <br />an approved record of the system, we can proceed without any <br />further action on your part. <br /> <br />If your sewage system is less than five (5) yea~s old, and we do <br />not have a ~ecord of an approved installation of the system~ <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 />You must have the septic tank pumped. <br />Nave she septic tank pumper complete the form below. <br />A field uisit will be required by the Sanitarian to verify <br />the location and condition of the septic system. <br />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 />required. <br /> <br /> For Septic Tank ~%%m~r ~s~ O~ly <br /> <br />AP~ROXI~E SIZ~ OF SEPTIC TANK: . /~ gallons <br /> <br /> TANK IN ~ CONDITION? ~ yES; NO <br /> <br />ARE BAPP~E$ OR ELBOWS IN PLACE? <br /> <br />IS DRAINFIELD SACKING UP INT0 TANK? <br /> <br /> If yes, explain; <br /> <br />SEPTXC TANK MATERIAL: <br /> <br />NO <br /> <br />NO <br /> <br />Concrete Steel .~ Other <br /> <br />DIAGRAM OF SOUSE AND <br />LOCATION OF TANK: <br /> <br />example <br /> <br />Rev 7/89 pb <br /> <br />W <br /> <br />SIGNATURE OF PUMPE ' . <br /> <br />E <br /> <br /> <br />