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',. . ..~ ..k . .~. ,/,.,~.,,,,, ...... <br /> <br />~OK 9~01 SEPTIC TANK PUMPING <br />F CSo ss .7 s INSPEC ON FORM <br /> <br />The fallowing requirements apply to the evalualfon ol'an e~isling on.~ite ~ewage Syster~ Please select I~e appmp~ate <br />section and fol~ the d~'~ons Mrefully, <br /> <br />1. If your sewag~ wstem is ~ ~ ~ve (5) ye~s old and ~ Ce~ficate of S~fac,~ty Complelion I~ been I~sued for <br /> the system, the sepUo tank does not ~e~uire pumping at I~is time. A f~ld inSrree- --UO~ wm be made ~t~eentire system <br /> and a repart wilt be issued. <br /> <br />2. If your sewage syslle~ is more than fr,'e (5) year.~ old a~d the septic lank has not been pumped wi~ln the fast five (5) <br /> yearn, f~[o.w the ~i~_'~ below. If you have IX~f ~ the septic ak has be~m pumped within the last five tS) <br /> ye~, rs, (A) will not be required. <br /> <br /> A. The sepl~c tattk must be pumpe~[ b/a DEQ lioer, sed Sol'tie ta~k pumper. <br /> S. The sep~ tank pumper must complete the form below. <br /> A field inspedion will be required by our on-site staff to venYy the location and cond~on of 'the sept~ system. <br /> <br />" FOR SEPTIC PUMPER USE ONLY <br /> <br />Company N~"n~ ~ <br />propu~ Add.ss: ' <br />Proper~.Owne~. ~[~, ~M <br />~p~ Tank M~ ~ ~ ~l ~hec <br />~s Tank in GO~ ~d~n? Y~ N~ If No, pl~se ~lain: <br />Am inlet & o~et ~ngs ~ p~? Y~ / No <br />Is dis~ ~e~ ~ ~ ~ Y~ No/If Yes. exp~n: <br /> <br />~3ize of Tank: ~,~)' .g~l]o~ls <br /> <br />if an effiuer~t pump is inelude~ as part of the r,e~c system, the dosing ~ank and pump assembly must be inspac~ed and <br />cleaned when the septic tank is puml:)ed. <br /> <br />DIAGRAM OF HOUSE AND SEPTIC TANK', SHOW DETA[L AND MEASUREMENTS: <br /> <br />N <br /> <br />MAY /? <br /> <br />MARION COUNTY <br />BUILDI{~IC~ IN'~PE,,TION <br /> <br />DATE OF PUMPING <br /> <br />MGI~'$1~REV 4,96 <br /> <br /> <br />