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D.E.C~ LICENSE NO.33008P-!.B.B. N0.85813 <br /> <br />ADDRESS OF TANK PUMPED:'""~K~"~E~,~F~,~ APd C ~.. <br /> <br />LOCATION OF LID ~ <br />APPROXIMATE SIZE OF TAN~: ~/~?C?~C)v~ GALLONS <br />TANK CONDITION? GOOD 7-,, FAIR CONCRETE.~_~X OTHER <br />ARE BAFFLES OR ELP, OWS IN PLACE? YES ~ NO <br />EFFLUENT PUMP-'~J?~ PUMP TANKS DOSING SYSTEMx12~> <br />DRAINFIELD WORKING ~/~G SURFACING ~1,~__ c~SLUGGISH <br />SOLIDS. NORMAL~'g~PEXCESSIVE <br />REPAIR NEEDS: INLET~D~ OUTLEt(DF--MAINLINE <br /> LID DC <br />HOUSE VACANT__ OCCUPIED._~ <br />NUMBER OF PEOPLE IN HOME: PRESEN~ I PREVIOUS.__ <br />NUMBER OF YEARS SINCE LAST PUMPING <br /> I N T E R V A L: ~'~"ux/fi~/~])/~- ~/ <br /> <br />RECOMMENDED PUMPING <br /> <br />SIGNATURE OF <br /> <br />PUMPER: <br /> <br />DATE: <br /> <br /> <br />