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Marion County ON-SITE S~WAGE SYSTEM <br /> <br /> The following requirements apply to the evaluation of an existing on-site <br /> sewage system. Please select the appropriate section and follow the directions <br /> carefully. <br /> <br /> 1. If your sewage system is less than five (5) years old and a <br /> Certificate of Satisfactory Completion has been issued for ~he <br /> system, the septic tank does not require pumping at this time. A <br /> <br />....... ~-~ld inspection will be ~ade of the entire system and a report <br /> <br /> 2. J~ your sewage system is moro than five (5) years old and the <br /> &,l~ 1 ~ ~Q-,- %e~tie tank has not be~n pumped within the last five (5) years, <br /> ~OO ~ u |~O3 follow tho directions below. If you have proof that the septic <br /> tank has been pumped within the last five (5) years, sections (a) <br /> ~AS~0N ¢0UNYY and (b) will not be required. <br /> BU~tDING {NSP~GT~0N a. The septic tank must be pumped by a D.~.Q. licensed septic <br /> tank pumper. <br /> b. The septic tank pumper must complete the form below. <br /> A ~ield inspection will bo ~equi~od by ou~ on-site staff to <br /> verify the location and condition of the septic system. <br /> <br />MClS-Sl9 <br />REV 10-92 <br /> <br />COMPANY NAME= <br /> <br />PROPERTY OWNER: <br /> <br />PROPERTY ADDRESS: <br /> <br />*for septic pumper use only* <br />(please print) <br /> <br />APPHOX~TE S~Z~ OF TANK~ ~ / ~I~ .gallons <br />SEPTIC TANK MATERIAL: Concrete..~.; Steel., ; Other <br /> <br />IS TANK IN GOOD CONDITION? ............. Yes ~ ; NO <br /> <br /> If "No", explain: <br /> <br />APd~ INLET & OUTLET F~TTINGS IN PLACE? .. Yes ~ ; No <br /> <br />IS DISPOSAL FIELD BAOKING INTO TANK? ... Yes <br /> <br /> If "Yes", explain= <br /> <br />DIAGR~24 OF HOUSE AND SEPTIC TANK: <br /> <br />; No ~- <br /> <br />MARION COUN'FY <br />r~;UltDtNG INSPECTION <br /> <br />(503) 588-5147 <br /> <br />I' <br /> <br /> (show detail with measurements) <br /> <br /> ', <br /> <br /> t,. <br /> <br /> DAT~ OF PUMPING <br /> <br />8uiidlng, S ~~ <br /> <br /> <br />