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Is order to properly evaluate 3OU~ existing sewage system, the <br /> following information will be n~oessary: <br /> <br /> 1. If your sewage System is less than five (5) years old, <br /> and we have a record of t-~ system, we can proceed <br /> without any further action on your part. <br /> <br /> 2. If your s~wage system is mo.~.e than five (5) years old <br /> aNd/or we ~0 not have a record of the system: <br /> <br /> a. It will be necessary no have the septic tank <br /> <br /> b. Have a D~Q licensed septi0 tank pumper complete <br /> the form beiow <br /> o. A field visit will be required by th~ Sanitarian <br /> tO verify =he location and condition of the septic <br /> system <br /> d. If you have proof that your septic tank has been <br /> pumped within the last five (5) y~ars, sections a <br /> an~ b above will not be raguired. Provide <br /> verification of pumping (receipt from pumpe~) to <br /> this of~ice. <br /> <br />~PROXZ~T~ ~Z~ OF SEPTIC T~K~ ~ <br />IS T~K IN ~D CO~ZTION? YES: /' NO: <br /> <br />D~GRA~OF HOUSE AND <br />LOCATION OF TA/~: <br /> <br /> ;-,-7 .... : <br /> <br /> .... <br /> <br /> .... . .~ <br /> <br />3/g2 Re~ 10/87 <br /> <br />W <br /> <br /> <br />