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The following requirements ap!~ly to the evaluation of an existing on-sit~ <br />sewage ~ystem. Please select the appropriate section and fo~kow the <br />carefully. <br /> <br />1. If your sewage system i~ less than five ~5) ~ars old ~nd a Certificat~ <br /> of Satisfactory completion ha~ been issued for the system, the ~eptic <br /> tank does not re~ire pumping at this time. <br /> a. Authorization Notices d~..not, re~ire a ~ield in~peotion of the <br /> system. A re~rt can be issued based on a review of our files. <br /> b. Existing System Evaluations ~' re~ire a field inspection of <br /> entire system and a ~port will be issued. <br /> <br />If your sewage system is more than five {5) years old and the septic <br />tank has not been pumped within the last five (5) years, follow the <br />directions below. If you have proof that the septic 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 pumper must complete the form below. <br /> Authorization Notices and ~xisting System Evaluations require a <br /> field inspection to verify the location and condition of the <br /> septic system. <br /> <br /> *for septic pumpe,r use on~y* <br /> <br /> ~ · <br /> <br />SEPTIC TANK MATERIAL: Concrete. _ <br />IS TANK IN GOOD CONDITION? ............. Yes <br /> <br /> If "No", explain:= <br /> <br />ARE INLET & OUTLET FITTINGS IN PLACE? ,. Yes ~z~ ; <br /> <br />IS DISPOSAL FIELD BACKING INTO TANK? ... Yes_ ; <br /> <br />If "Yes", explain: <br /> <br /> gallons <br />Other = <br /> <br />No ~ <br /> <br />DIAGRAM OF HOUSE AND SEPTIC TANK~ {show detail with measurements) <br /> <br /> N <br /> <br /> MARION COUN'Pt' <br /> BUILDING INSPECTION <br /> <br />~ATE OF PUMPING <br /> <br />~ICN~T~RE OF PUMPER <br /> <br />MC15-S19 <br /> <br /> <br />