Laserfiche WebLink
(Supplemental Form) <br /> <br />informa=ion will <br /> <br />~ fur~r ~c~ on ~our par:. <br /> <br />do ~oC have a re.rd of zz~ approved in$~alla=~on of the system~ <br /> <br /> I~ ~our sewage $g$~em is more =hen five {5) gears old or ham no= <br /> <br />~, you m~$c have =he se~=~c t~k pum~d. <br /> <br />c. A field vlsi= will be required bg =he Sanitmri~ ~o <br /> ver~f~ the location ~d ~n~it~on of =he sep=l~ sys=em. <br /> <br /> will not be requir~, <br /> <br /> -For Se~¢ic Tank"Pumper U=~' OnlW- <br />Stayton Septic Service <br /> <br />DEQ LICENSE NO: <br /> <br />PROPERTY OWNER: <br /> <br />34916 <br /> <br />ADDRESS WHER~ T~¥K PUMPED= <br /> <br />Aumsville, OR <br /> <br />~°PROXIMATESZZEOFSEPTIC 9ANK; 1000,, <br /> <br />. gallons Concrete <br /> <br />IS T~¥K IN GOOD <br /> <br />~RS BAFFLES OR ELBOWS IN <br /> <br />IS DRAINFIELD BACKING UP iN~O TANK? <br /> <br /> If ~es. explain;, ,, <br /> <br />XX Y~$~ NO <br />XX Yg$; NO <br />YgS; XX ~0 <br /> <br />DIAOP~J4 OF HOUSE AND <br />LOCATION OF T~¥~: <br /> <br />3/86 <br /> <br /> <br />