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(Supp.~menL~;- Form) <br /> <br />inform.?tion wil Z be <br /> <br />1. rf your se'~age system is _l.e.?~_ than fiv~ (~) gear$ old, an~ we <br /> haw? an appro';ed reco.-d gf the sUs~m, we can pmoce~8 w~thout <br /> a~g fur's;her action on ~o~r <br /> <br />2. If yOUr $ewlgO SW~em i8 <br /> <br /> If Hour s~'age System is mo~ than fiv~ (5} gears old or has no~ <br /> been pumped within tho last f~VU gears= <br /> <br /> · . YOU must ~v~ the septic tank pumped. <br /> b. Have th~ $ep6ic tank ~um~r complete the form below. <br /> c. A field visi~ will be required by the Sanitarian <br /> veri.fg the location ~d ~ndi=ion of the Se$~iC system. <br /> <br /> pumped w~thin ~he 2asr fivu (5) ~e=r$, s~ctions a & b <br /> will not be ~equ~red. <br /> <br />ADDRESS WHERE TANK PUMPED: <br /> <br />APPROXIMATE SIZE OF SEPTrC TANM:~--/¢~0 gall~n~ <br />~$ TANK ~ GOOD CONDITION? /YES; NO <br /> <br />rS DRAINE£~LD BACKING UR INTO ~ANK? ~S; ~ NO <br /> If y~=, e~plain; ............... <br /> <br />DIAGR~ OF ROUS~ AND <br /> <br />EXAM ~ 5~ : <br /> <br /> <br />