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(Supplemental Form) <br /> <br />i~forma¢ion w~ll be necessary= <br /> <br /> ~f gour sewage s~stem is less =hah five {5) ~ears old, and we <br /> have an ~pproved reco~d Of the sWstem, we can prOCeed without <br /> anw further action on gout l~art. <br /> <br />If gout s~age sgstem is less =ban five {5) gears old, and we <br />do ~o~ have a record, of an aSprov~d installation of the <br /> or; <br /> <br />b~n p~$ed wi=bin the last five gears: <br /> <br /> a. You muss hav~ The $eptic tank pum~d. <br /> <br /> A field visit will be required bw the s~itarian <br /> verifg th~ locat~ and condition of =he s~pt~ <br />d. If ~ou huv~ pr~f fha= ~our s~pt~c t~k has b~ <br /> <br /> wl21 nu= be required. <br /> <br />C~PAN¥ <br /> <br />PROPERTY OWNER: <br /> <br />ADDRESS WHERE TAN~ PUMPED~ <br /> <br />APPRfl~MATS SIZE OF SEPTIC TANK: <br /> <br /> -For Sep~i~ Tan~ Pumper Use Onl~~ <br /> <br />Staytou Septic Service , DE~ LZCENSN NO~ <br /> <br /> Michael T. & M~ra' Knight <br /> 10509 Staytou Rd. S.S. <br /> Aumsville, OR 97325 <br /> <br /> 750 metal <br /> ........... gallons <br /> <br />34916 <br /> <br />IS TANK ZN ~OOD C6~;DITZON? <br /> <br />ARE BAFFLES OR ELBOWS IN PLACE? <br /> <br />IS DRA~NFZELD BACMING UP ~NTO TANK? <br /> <br />XX <br /> <br /> IX <br />YES; NO <br /> <br />If yes, explain; <br /> <br />DIAORAN OF HOUSE AND <br />LOCAT/~V OF T~VK: <br /> <br />Tank <br /> <br />Tan~ is in concrete slab in shop. <br /> <br /> <br />