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SEPTIC TAHK EVALUATION <br /> <br />PROPERTY OI~NER <br /> <br />ADDRESS OF EVALUATION <br /> <br />RECBVED <br /> <br /> MAY 0 5 '1999 <br /> MARII1M CIIIIN TV <br />iBUILDING INSPEI~.~J}N <br /> <br />-To Be Completed By Septic Pumper Only- <br /> <br />cor.tPANY NAI.)E Mike's Septic Service <br /> <br />DEQ LICENSE NUHBER 33519-P <br />DATE OF TANK PU,IPI~G ~J~--~ <br />SEPTIC TAHK IqATERIAL~CAPACITY OF <br /> <br />IS TANK IN GOOD CONDITION? ~YES <br />ARE.BAFFLES AND ELBOI.TS IN PLACE? ~ES <br /> <br />IS DRAINFIELO BACKING UP INTO TANK? YES <br /> <br />TANK <br /> <br />-Diagram of House and location of tank~ <br /> <br />N 0 <br />NO <br /> <br />GALS, <br /> <br />I pumped and inspected this septic tank and found conditions as no~ed <br />above on this date. This is a limited inspection and makes no guarentees <br />concerning future performance of this system. ~' <br /> <br /> -Signature of pumper- <br /> <br /> <br />