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site #:. <br /> <br />The following <br />carefully. <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 Certificate <br /> of Satisfactory Completion has been issued for the ~ystem, the septic <br /> tank does not require pumping et this time. <br /> a. Authorization Notices do not require a field inspection of the <br /> system. A report can be issued based on a review of our files. <br /> b. Existing System Evaluations d_~o require a field inspection of the <br /> entire system and a ~eport will be issued. <br /> <br />2. If your sewage system is more than five ~5) years old and the septic <br /> tank has net been pumped within the last five {5) years, follow the <br /> directions below. I.f you have proof that the septic tank has been pumped <br /> within the last five (S) 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 /> The septic tank pumper must complete the fo~m below. <br /> Authorization Notices and Existing System Evaluations require a <br /> field inspection to verify the location and condition of the <br /> septic system. <br /> <br /> *for septic pumper use only* <br /> <br />PEo T¥I Oct ! Am&q- cl,, lOC. <br /> <br />APPROXI~T~ SIZE OF T~K: ~ , gallons <br />SEPTI~ TANK ~TERtAL: Concrete ~; S:eel -. ; Othe~ <br />~$ TANK IN G~D CONDITION? ............. Ye$~ ; No <br /> <br /> If "NO", expla£n: <br /> <br />ARE INLET & OUTLET FITtiNGS IN PLACe? ,. Yes ~ <br />IS DISPOSAL FIELD BACKING INTO TANK? ... Yes <br /> <br /> If "Yes", explain: <br /> <br />DIAGRAM OF HOUSE AND SEPTIC TANK: <br /> <br /> N <br /> <br />(show detail with <br /> <br />MARION OOUNTY <br />BUILDING INSPFDI'ION <br /> <br /> DATE OF PUMPING <br /> <br />~SrG~A~URE OF PU~ <br /> <br />MC15-$19 <br /> <br /> <br />