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~EPTIC TANK <br /> <br />~..~' DEC 2 8 19~2 <br /> MARION COUNI'~ <br /> BUILDING INSPECTION <br /> <br />TIiE SEPTIC TANK AT; <br /> <br />WAS PUMPED BY: <br /> <br />DATE TANK PUMPED: <br /> <br />(~[icensed D.E.Q. pumper) <br /> <br />THE TkNK WAS: <br /> <br />[ ] FILLED <br /> <br />FILL MATERIAL: <br /> ~ ] REJECT SAND <br /> [ ] BAR RUN GRAVEL <br /> £ ~ cRUS~O ROC~ <br /> <br />ENCLOSE A COPY OF THE PUI~PING RECEIPT WITH THIS FORM, <br /> <br /> <br />