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(Supplemental Form) <br /> <br />In order to properly evaluate your axi$~ing sewage system, ths following <br />informatio~ will be nscessarg~ <br /> <br />rf ~our sewage s~s~em is les~.. :han flys (§) years old, and we <br />have a~ approved mccord of the system, we can proceed without <br />~y kurther action On ~our part. <br /> <br />If your sewage $~$tem is less than five (5) years old, and wc <br />do DOt have a record of an approved installation of the <br /> or; <br />If gout sewage system i$ more thae five (5) ~ears old or has <br />b~n pumped ~zithin th~ last five ycars: <br /> <br /> ~'ou must have the septic tank pumped. <br />h. Haw? th~ septic tank pump~ complet~u the fo~'~ bolow. <br />c- A f!¢ld visit will be required by the Sani=aria~ to <br /> verify the location and ¢ondi=ion of the septic system~ <br /> If yo~ have ~roof that your septi¢ =ank has been <br /> pumped within the last five {$) years, sections a & b <br /> w~ll ~o~ be required. <br /> <br />APPROX~.~ATE SIZE OF SEPTIC TANK: <br />IS TANK IN GOOD CONDITION? <br /> <br />ARE BAFFLES OR ELBOWS IN PLAC~) <br />rS DRA~NFI~LD BACKING UP INTO TANK? <br /> <br /> If gOS, ex~iain; <br /> <br />-For Septic Tank Pumpez' use only- <br /> <br />DfAORA~; OF HOUSE AND <br />LOCATIC%¥ OF <br /> <br />EXAMPLE: <br /> <br />, <br /> <br />........... <br /> <br /> <br />