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sewage <br />carefully. <br /> <br />~ite #: <br /> <br />SEPTIC T~d~K P~IN~ PJ~D i~SPECTiON FO~M <br /> <br />requirements apply to the evaluation of an existing oh-site <br />Please select the appropriate section and follow the directions <br /> <br />If your sewage system is less than five {~) ¥¢are o~d and a <br />Certificate Of Satisfactory completion has been issued for the <br />system, the septic tank does not requir~ pumping at This ~lme- A <br />field ins~ection wi~t be made of the entir~ system and a reI~Prt <br />will be i~sued. <br /> <br />If your sewage system i~ more than iive ($) years old and the <br />septic'tank has not been pumped within the last five (~) years, <br />follow the directions below. ~f you hav~ proof tha% the ~eptic <br />tank has been pumped within the last fiv~ (5) years, sections (a) <br /> <br /> a. The septic tank must be Pumped by a D.E.Q. Iieensed septic <br /> tank pumper. <br />b. The septic tank pumper must complete the form below, <br /> A field inspection will be required by our on-si~e staff to <br /> verify the location and condition of %he $~ptic Dystem, <br /> <br />*for sept&o pumper u~e only* <br />(please print) <br /> <br />APPROXIMATE SIZE OF TANK: .... ~ ., gallons <br />SE~TIC TANK MATER/AL: Concrete ,~ ste~l., ; O~her <br />IS TANK IN GOOD CONDITION? ............. Yes~ ; No <br /> <br /> If "No", e~pla, in: . .... <br />ARE INLET & OUTLET FITTINGS IN PLACe? ,. Yes /; Nq ~ <br /> <br />IS DISPOSAL FIELD SACKING INTO TANK2 ... Yes ....... ; NOZ/ <br /> <br />If "Yes", e×plain: <br /> <br />DIAGPJqM O~ HOUSE AND S~PTI~ TANK= <br /> <br />(show detail with measurements) <br /> <br />MCIS-s19 <br /> <br />($03) S88-5147 <br /> <br />Se )i~tor 8~ dd~n8, :~t)d Fio0r <br />220 High St. Ng, Sa e *~, OR 97301-$670 <br /> <br />~NATURE OF PUMPER <br /> <br /> <br />