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Marion County ON-SITE SEWAGE SYSTEM <br />OREGON SEPTIC TANK PUMPING kND INSPECTION FORM <br /> <br /> The following requirements apply to the evaluation of an exzsting on-szte <br /> sewage system. PLease select the appropriate section and follow the directions <br /> carefully. <br /> <br /> 1. I f your sewage ~ystem ~3 Less ~al] five , :~; years ~ Id and a <br /> <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 than fzve (5) years old and the <br />septic tank has [lot been pumped within the iasc five <5) years, <br />follow the directions below. 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 />a. The septic tank must be pumped by a D.E.Q. licensed septic <br /> tank pumper. <br />b. The septic tank pumper must complete the form below. <br />c. A field inspection will be required by our on-~ite staff to <br /> verify the location and condition of the s~ptic system. <br /> <br />PROPERTY OWNER: <br /> <br />PROPERTY ADDRESS: <br /> <br />*for septic pumper use only* <br /> ~please print) <br /> <br />APPROXIMATE SIZE OF TANK: {''(~C'~ <br />SEPTIC TA/~K MATERIAL: Concrete ~ ; Steel <br /> <br />IS TANK IN GOOD CONDITION? ............. Yes <br /> <br />gallons <br /> <br /> MAY 5 <br /> <br /> If "No", explain: <br /> <br />AJ~E INLET & OUTLET FITTINGS IN PLACE? <br />IS DISPOSAL F%ELD BACKING INTO TANK? <br /> <br /> If "Yes", explain: <br /> <br />; No__ N AR ON COUNTY <br /> No BU;LD!NG INSPECTION <br /> <br />DATE; OF PUMPING <br /> <br />MCiS-S19 (503) 5~,q-q147 5~na~o~ Buildin_8, ~n~ <br /> <br /> <br />