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Marion County <br /> <br />OREGON <br /> <br /> ON- SZ~L~E SEWAG~ <br />SEPTIC TANK pUMPING AN~ INSPECTION FORM <br /> <br />TEe following retirements apply to the evaluation of an existing on-site <br />~ewage system. Please select the app~0p=iate section and follow the directions <br />carefully. <br /> <br />If your sewage system is less than five (5) years old and a <br />certificate of Satisfactory completion has been issued for the <br />eystem, the septic ta~k does met require ~R~ing at this time. A <br />field inspection will be made of the entire system and a report <br />will be issued. <br /> <br />If your sewage system is more thaD five (5) years old and the <br />septic tank has not been pumped within the last five (5) years, <br />follow the directions b~low. If you have proof that the septic <br />tank has been pumped within the last five (5) years, sections (a) <br />and (b) Will not be required. <br /> The septic tank must be pumped by a D.E.Q. licensed mep%ic <br /> tank pumper. <br />b. The septic tank pumper must complete the form below. <br /> A field inspection will be req~ire~ by ~ur on-line staff to <br /> verify the location and condition of the septic system. <br /> <br /> COMPANY NA~E: <br /> <br /> APPROXIMATE SIZE OF TANK: ~)~ _gallons <br /> <br /> $~PTIC T~K ~TERIAL: Concrete ; Steel~ ; Other~ <br /> IS T~K IN ~D CONDITION? ............. Yes~; NO <br /> If "No", explain: <br /> <br />ARE INLET & OUTLET FITTINGS IN P~CE9 .. Yes <br /> <br />Is DISPOSAL FIELD BACKING IN~ T~? ... Yes <br /> <br /> If "Yes", explain: .......... <br /> <br />DIAG~ O~ HOUSE AND SEPTIC T~K: (show detail with measurements <br /> <br />*for septic pumper use only* <br />(please print) <br /> <br />DATE OF PUMPING <br /> <br /> <br />