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The followLng re~emen~s ap~y ~o =he eva~ua~ion ~f an existing on-s~e <br />sewage system. Please se~ec~ ~he ap~roDrlate 9ec~lon a~ follow =he <br /> <br /> Certificate of Sa=isfactory Comple~ion hn~ bee~ iesu~ for <br /> <br /> field inspection will be made.of the ent~ue syste= and a report <br /> will %e issued. <br /> <br />If your sewage system is more than five (5) years old and the <br />septia tank has not been pumped within the las~ five (5) years, <br />follow the directions below. If you have proof that ~he septic <br />tank has been pumped within the last five (5) years, sections (a} <br />and (b) will not b~/~e~u£red. <br /> a. The septic tank must b~ pUmped by-a-o~E.Q.~kice~sed septic <br /> tank pumper. <br />b. The septic tank pumper must complete the form below. <br /> c. A field inspection will be rec~:ired by our on-site staff to <br /> verify the location and cosdition of the septic system. <br /> <br />*for septic pumper Use only* . (please print) <br /> <br />~OXZ~TE SIZE o~ ?A~: <br /> <br />SEPTIC TANK MATERIAL: Concrete <br /> <br />IS TANK IN GOOD CONDITION?' . ............ <br /> <br /> If "No", explain-. <br /> <br />AP~ INLET & OUTLET FITTINGS <br /> <br />IS DISPOSAL FIELD BACKING INTO TANK? ... Yes <br /> <br /> If "Xes", explain: <br /> <br />DIAGRAM OF HOUSE AND SEPTIC TANK~ <br /> <br /> ? <br /> N <br /> <br /> gallons <br /> <br />Other ,, <br /> <br />(show detail with measurements} <br /> <br />MARION COUN'T~ <br />BUILDING INSPECTION <br /> <br />DATE OF PUMPING <br /> <br /> <br />