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AUT~0P.t ZATION NOTICE <br />(Supplemental Form) <br /> <br />2n order to properly evaluate you~ existing sewage sysc~ the following <br />information will be necessary: <br /> <br />]~ your sewage system is lea~ then five ($) years old, a~d we <br />heve a ~ecord of the sy$~e~, we can proceed ~lthout any ~u~ther <br />action ~ your par:. <br />~f your sewage system is'more than five (5) year~ old or we, _ ~ <br />~o not h.~e a record of the s--'---y~tem= .-'.D~~ <br /> <br /> a. It i~l be nec~a~ to ~ e ~ $ p~ ta po~pe~. ~ <br /> b. ~ave the septic tank pumper complete the ~o:m ~el~. _~ <br /> c. A fle~,d visit ~ill 5e required ~y the Sant,:arian to / ~/~ <br /> <br />pROPERTY <br /> <br />ADDRESS W~ERE TANK PU~IPED: <br /> <br />3/82 <br /> <br />zs rAN[ ZN ~OOV COSO~riO~? <br /> <br />DIAG~ OF HOUSE <br /> LOCATION OF T~: <br /> <br />EXAMPLE: <br /> <br />gallons <br /> <br /> <br />