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A & B SEPTIC SERVICE <br /> DEQ#38137 CCB# 155581 <br /> SALEM AREA 503-393-1311 OR ALBANY AREA 541-924-0851 <br /> P. O. BOX 444 ALBANY, OREGON 97321 <br /> Sewage Treatment System Report <br /> Date/Time Scheduled: 11/4 <br /> Site Address: 9931 KEENE LANE SE <br /> AUMSVILLE, OR 97325 <br /> Phone: 503-939-0403 <br /> A. General information: Obtain as much as possible when inspection is ordered. <br /> 1.) Property owner: JOHN MUDRICK <br /> 2.) Age of sewage treatment system approx UNKNOWN years <br /> 3.) Lot size 4.73 ACRES <br /> 4.) System Currently Serves: Residence: #of Bedrooms: 2 Occupied? Yes <br /> Commercial: #of Employees/Seating: Occupied? X No <br /> 5.) Number of people occupying dewlling: Currently 0 Anticipated <br /> If currently unoccupied, how long has it been vacant? 2 Months Years <br /> 6.) Has there ever been a backup in the house? E Yes El No X❑ Don't know <br /> 7.) List any known repairs made to the system: UNKNOWN <br /> 8.) Has the system recently been inspected by others? UYes El NO 2 Don't know <br /> If so, did it fail? El Yes El No III1 Don't know <br /> 9.) Is there a service contract for system components? LI Yes El Not Don't know <br /> 10.) Date tank or tanks were last pumped? UNKNOWN <br /> Additional Comments: <br />