Laserfiche WebLink
Marion County O~-SIT~ SEWAGE SYSTEM <br />O R[G ON S~PTIC TANK PUMPING AND INSPECTION FORM <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 /> i. If your sewage system is less than five (5} years old a~d a <br /> certificate of Satisfactory Completion has been issued for the <br /> system, the septic tank does not require pump£ng at this time. A <br /> · field inspection will be made of the entire system and a report <br /> will be issued. <br /> <br />If your sewage system is more than five (5) years old and the <br />septic tank has not been pumped within the last five (5) years, <br />~ollow the directions below. If you have proof that the septic <br />tank has been pumped within the last five (5) years, sections (a) <br />and (b) will not be required. <br />a. The septic tank must be pumped by a D.E.Q. licensed septic <br /> tank pumper. <br />b. The septic tank pumper must complete th~ form below. <br />c. A field inspection will be required by our on-site staff to <br /> verify the location and condition of the septic system. <br /> <br />PROP~'RTY OWNER: <br /> <br />*for septic pumper Use only* <br />(please print} <br /> <br />PROPERTY ADDRESS: <br /> <br />APPROXIMATE SIZE OF TANK:/ /(~ gallons <br />SEPTIC TANK MATERIAL.* Concrete ~; Steel__; Other <br /> <br />IS TANK TN GOOD CONDITION? ............. Yes ~ ; No__ <br />If "No", explain= <br /> <br />ARE INLET & OUTLET FITTINGS IN PLACE? .. Yes <br /> __; NO__ <br /> <br />IS DISPOSAL FIELD SACKinG INTO TANK? ... Yes <br /> <br /> ~f "Yes", explain.. <br /> <br />DIAGRAM OF HOUSE AND SEPTIC TANK: (show detail with measurements) <br /> <br /> ? <br /> N <br /> <br /> ~-.~..~., <br /> <br />DATE OF PUMPING <br /> <br />MC15-$19 (503/ .$88-5147 Senalor Building, 2nd Floor <br /> <br /> <br />