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Marion County site <br /> <br />The following retirements apgly to the evaluation of an existing on-site <br />~ewage ~ystem. Please select the appropriate section and follow the directions <br />carefully. <br /> <br />1. If your sewage system is .less than f~ve (~),,years old and a Certificate <br /> of satisfactory Completion ha~ been issued for the system, the septic <br /> tank does ~ot re, ire pumping at thia time. <br /> a. Authorization Notices d0:: no% fe~ire a ~ield inspection of the <br /> ~ystem. A re~rt can be issued based on a review of our files. <br /> b. Existing S~stem Eva!nat%ohs d~ re, ire a field inspection of the <br /> entire system and a r~rt will be issued. <br /> <br />2. If your sewage system is more ~than five [53 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 p~0o~ ~hat the septic tank has been pumped <br /> ,,~!,thln th~ !a~t five (5) year~,::sec~ol~ (a) will non be re~ired. <br /> a. The septic tank must be pum~d by a D.E.Q. licensed septic ~ank <br /> pumper. <br /> ~. The septic tank pumper mu~t complete the form below. <br /> c. Authorization Notices and: Existing System Evaluations require a <br /> field inspection to veri'fy the location and condition of ~he <br /> <br /> *for septic pumper,use only* <br /> <br /> SEPTIC TANK MATERIAL: Concrete~ ; Bte~l ; <br /> <br /> ' Yes <br /> IS TANK IN GOOD CONDITION? ............ <br /> <br /> If "NO", explain: <br /> ARE INLET & OUTLET FITTINGS IN PLACE? .. Yes ~ ; <br /> IS DISPOSAL FIELD BACKING INTO TANK? ..i. <br /> <br /> DIAGRA~M OF HOUSE AND SEPTIC TANK: <br /> <br /> N <br /> <br />568-5147 Senator <br /> <br /> gallons <br /> Other <br /> <br />; NO____ <br /> <br />NO <br /> <br />No ~ <br /> <br />(show detail with measurements) <br /> <br /> <br />