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The following r~irements ~pply to the. evaluation of an ~xisting on-site <br /> ~ewag9 system, please select the appropriate section and follow the directions <br /> <br /> If your sewage system i~ less ~han five (5) years old and a <br /> Certi~icate of satisfau%ory Completion has ~een [s~ued fo~ the <br /> syst~, the septic tank dOeS mo~ req~ir~ pumping at this tim~. A <br /> <br /> m~m%,~~ld ins~ction will be mad~ of ~he entire system and a report <br /> <br /> ~O~ ~O3 follow the directions ~low, If you have proof that the s~ptic <br /> tank has been pum~d within t~ last five (5) year~, s~ctions (a) <br /> ~%0N COUN~ and (b) will not be required. <br /> The septic tank must be pumped by a D.E.Q. licensed septic <br /> BU~LO(NG INSPECTION a. tank pumper. <br /> b- The ~eptio tank pum~r mus: complete the form below. <br /> c. A ~ield inspection will be ~e~ired by our on-site staff to <br /> verify ~he location and condition of the septic system. <br /> <br /> *for septic pumper use only~ <br /> ~ (please print) <br /> <br /> .... <br /> <br />sEPTIC TANK MATERI~ Concrete...~.; S~e~ ..... ; <br /> <br /> I$ TANK ZN GOOD CONDITION~ ............. Yes ~ ; <br /> <br /> If "No", explain: <br /> <br />A~ INLET ~ OUTLET F~TTING$ IN PLACE? ,. Yes ~ ; <br /> <br />IS DISPOSAL FIELD BACKING INTO TANK? ... Yes . <br /> <br /> If "Yes", explain=. <br /> <br />DIAG~ OF ~OUSE A~ S~PTIC TANK: <br /> <br />MC15~S19 <br />REV lO-92 <br /> <br />(503) 588=5147 <br /> <br /> ,gallons <br />Other <br /> <br /> NO <br /> <br />(show detail with measurements) <br /> <br /> ', <br /> <br />MARION COUNTY <br />BUN.DING INSPECTION <br /> <br />220 High St. NE, Salem, OR 9~"~O1,3670 <br /> <br /> <br />