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The £oZ~owin~ requirements 'apply %0 the evalua:ion of an existing on-aite <br />~ewage system. Pleaee select'the appropriate section and follow ~he directions <br />carefully. <br /> <br /> Zf you~ sewage system is less than $~ [5) years old and a Certificat~ <br /> of satisfactory Completion has been i~ued for the system, the septic <br /> ~ank does m~t reguire pumping at this t im~. <br /> a~ A~thbrization Notices d° n~ regnlire a field ink,orion of the <br /> syst.~. A ~e~t can be issued based on a review of ou~ files. <br /> b. ExiSting System Eva%gate,ns d~ re~ire a field ins~ction of th~ <br /> entire system and a N~port will b~ issued. <br /> <br />2. If your sewage ~ystem is more tha~, f.ive (5) ~earz old and the septic <br /> ~ank has not been p~m~d ~ithim :he last five (S) years, fol~Ow ~he <br /> dl~e~ions below. If you have proof that the septic tank has been pu~ped <br /> within ~he last five (~) years, section (a) will not be required. <br /> <br /> pumper. <br /> b. The septic ta~k pum~r must complete the form below. <br /> c. authorlzatlo~ I{oticem enO' ~s~in~ -Sys6~m"Evalu~{ions' re~uir~ a <br /> field ins~tion to verify the location and condition of the <br /> <br /> APPROXI~A~ SIZE OF TANK: //~O ~allons <br />SEPTIC TANK MATERIAL: Concret~ ; Steel ; Other <br />IS TANK IN ~D CONDITION? ..... <br /> <br /> If "No", ~xplai~: <br />ARE INLET & OUTLET FITTINGS IN PLAG$~ .. Yes~ ; NO <br />IS DISgOSAL FIELD BACKING INTO T~K? <br /> <br /> If 'Yes", explain: <br /> <br />DIAG~ OF ROUSE AND EEPTIC TANK: (show detail wi~h mea~ur~ents) <br /> <br /> N <br /> <br />(503) 588-5147 Senator Su~ldln~ <br />~ IqfY~% RRR-'/(IZJ~ :'20 Hi~k ,~t, N~- - S~lem, OR 97~1~70 <br /> <br />1 7 l J3 <br /> <br />MARION COUNI¥ <br />BUILDING. INSPE~'[I.ON <br /> <br />MCI 5-S19 <br /> <br /> <br />