Laserfiche WebLink
The following <br />sewage system. <br />carefully. <br /> <br /> ON-SITE SEWAGE SYSTEM <br />SEPTIC TANK PUMPING AND INSPECTION FORM <br /> <br />requirements apply to the evaluation of an existing on-site <br />Please select the appropriate section and follow the directions <br /> <br />If your sewage system is less than five (5) years old and a <br />certificate of Satisfactory completion has been issued for the <br />system, the septic tank does not require pumping at this time. A <br />field inspection will be made of the entire system and a report <br />will be issued. <br /> <br />If your sewage system is more than five (5) years old and the <br />septic tank has not been pumped within the last five (5) years, <br />follow the directions below. If you have proof that the septic <br />tank has been pumped within the last five (5) years, sections (a) <br />and (b} will not be required. <br />The septic tank must be pumped by a D.E.Q. licensed septic <br />tank pumper. <br />b. The septic tank pumper must complete the form below. <br />c. A field inspection will be required by our on-site staff to <br /> verify the location and condition of the septic system. <br /> <br /> *for septic pumper use only* <br /> (please print) <br /> <br />coMPANY MANE: <br /> <br />PROPERTY OWNER: F~~k <br />PROPERTY ADDRESS= <br /> <br /> _gallons <br />SEPTIC TANK MATERIAL: Concrete__; Steel~_~__; Other__ <br />IS TANK IN GOOD CONDITION? ............. Yes V ; No <br />If "No", explain: <br />ARE INLET & OUTLET FITTINGS IN PLACE? .. Yes V ; No <br />IS DISPOSAL FIELD BACKING INTO TANK? ... Yes .; No V <br />If "Yes", explain: <br /> <br />DIAGPJkM O~ HOUSE AND SEPTIC TANK: (show detail with measurements <br /> N <br /> <br />MC15-S19 (.503) 588-5747 Senator Buildins, 2nd Floor <br />REV 10-92 220HghS NE,Sae'n, OR97'~ -3f7( <br /> <br />DAT~ O~ P~MPING <br /> <br /> <br />