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In order to properly evaluate your ex%s&iBg sewage system, the following <br />information will be aeoessary: <br /> <br />If your Sewage system is less than five (5) years old, and we have. <br />an approved record of the system, we can proceed without any <br />~urther action on your part. <br /> <br />If your sewage system is less than five (5) years old, and we do <br />not have a record of an approved i~stallatiou of the system: <br /> <br />or: <br /> <br />If your sewage system is mo~e tI%an five (5) year~ old or has not <br />been pumped within the lest fiv~ yea~s; <br /> <br /> a. You mu~t have the septic tank pumped, <br /> b. Have the septic tank pumper complete the form below. <br /> c. A ~ield visit will De required by the sanitarian to v~rify <br /> the loca=ios and Con~itioB of =he septio uy=tem. <br /> d. If you have proof %bat you~ septic tank has been pumped <br /> within the la~= ~iv~ (5) years, section~ a & b will not be <br /> required. <br /> <br />COMPANY N~E~ A A A ~eDtic Service I~;C. D~ LICENS~ N0. 36949 <br /> <br />APPROXI~T~ S~ZR OP SEPTIC ~ANK: ............ gallons <br /> ~s; ....... .o <br /> _ ~ ~o <br /> <br /> IS TANK IN GOOD CONDITION? <br /> <br />A~E BAFFLES OR ELBOWS ~N PLA~E? <br /> <br />Z$ DRAINFI~LD BACKrNG UP INTO TANK? <br /> <br /> If yes, explain; <br /> <br />SEPTXC TANK MATERIAL: <br /> <br />DIAGRAM OF H6USE AND <br />LOCATION OF TANK: <br /> <br />Other <br /> <br /> ... <br /> <br />E <br /> <br /> <br />