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01. 12. 95 12:19 PM *FLOR SALEM RELD 734 P02 <br /> AUTHORISAT~ON NOTIC£ <br /> (Supplem~nt&l Form) <br /> <br /> an approved reeor~ of the system, we can proceed without any further <br /> action On yOUr part, <br /> <br /> a. You must have the septic t~nk pumped, <br /> <br /> ~. A field vts£t will be ~e~uire~ b~ the San~taraian to verl~y =he <br /> <br /> you hove proo£ ~hat your septic ~ank has been pumped within the <br />lest five (S) yea~e, sections & & b will not be ~equi~ed. <br /> <br />For Septic Tank Pumper Use Only <br /> <br />PROPERTY O~ERt <br /> <br />APPROXIHATE SZZR OF HEPT2~ TA~K: <br /> <br />IS TARK IN GOOD CONDITION? <br /> <br />ARB BAFFLES OR EL~0W$ IN PLACe? <br /> <br />IS DRAINFIE~D BIll, KING UP INTO TANK? <br /> <br /> if yeS, explain~ ................ <br /> <br />~ Y~S; NO <br />__.__.__YES~ ~NO <br /> <br />Steel <br /> <br />Other............. <br /> <br />LOCATION OF TA_~: <br /> <br />3/82 Rev 10/87 <br /> <br /> <br />