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The follow£ng <br />sewage system, <br />carefully. <br /> <br /> Site #: <br />ON-SITE SEWAGE SYSI~U4 <br /> <br />apply to the evaluation of an existing <br /> <br />1. If your sewage system is less_~han ,,five IS) year~ old a~d a Certificate <br /> of Satisfactory Completion has been issued for the system, the septic <br /> tank does not require pumping at this time. <br /> a. Authorization Notices d~) not require a field inspection of the <br /> system. A report can be i~sued based on a review of our files. <br /> b. Existing System Evaluations d__o ~equire a field inspection of ~he <br /> entire system and a report will be issued. <br /> <br /> If your s~wage system is ~o~, than ~ive (5}. years o~d and the septic <br /> tank has not been pumped within the last five (5) yea~s, follow the <br /> directions below. If you have proof that ~he ~ep~ic tank has been pumped <br /> within the last five (5) years, section (a) will not be required. <br /> a, The septic tank must be pumped by a D,E.Q. licensed septic tank <br /> pumper. <br /> b, The septic tank pum~er must complete the form below. <br /> Authorization Notices and Existing System Evaluations requi~e a <br /> field inspection to verify the location and condition of <br /> septic system. <br /> <br />COMPLY N~: S~tic ~i~s D.g.O. LICENSE ~:349~6 <br /> <br />pROPERTY OWNER: Ertk & Janioe Wasmann <br /> <br />PROP=RTY AO~SS: 8188 Silver Falls Highway <br /> <br />Aumsville, OR 97325 <br /> <br />APPROXIMATE SIZ~ OF TANK: 500 gallons <br /> <br />SEPTIC TAJ~K ~iATERIAL: Concrete X~; Steel ; Otber~ <br /> <br />IS TkNK IN GOOD CONDITION? ............. Yes X ,; No <br />If "NO", explain: <br /> <br />ARE ~NLgT & OUTLET FITTINGS IN PLACE? .. Yes~ ; NO .... <br /> <br />IS DISPOSAL FIELD BACKING INTO TANK? ... Ye~ X ; NO <br /> <br /> If "~es", explain: Replaced entire system with new tank & ~rainfield. <br />DIAGPJLM OF ~OUSE AND SEPTIC TANK= (show detail with measurements} <br /> <br />(503) 588-5147 <br /> <br />***NOTE: New system has <br /> 1500 gallon Combo <br /> tank and 450 feet of <br /> drainfield with short <br /> lines. <br /> <br /> 1~/10/93 ,, <br />DAT~ OF PUMPING <br /> <br />SIGNATURE OF PUMPER <br /> <br />MC15-S19 <br />R~V ~/93 <br /> <br /> <br />