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AUTHORIZATION NOTICE/EXISTING SYSTEM EVALUATION <br /> <br />PUMPER FORM <br /> <br />In order to properly evaluate your existing sewage <br />following information will be necessary: <br /> <br />system, the <br /> <br /> 1. If your sewage system is less than five (5) years old, <br /> and we have a record of t-~ system, we can proceed <br /> without any further action on your part. <br /> <br /> 2. If your sewage system is more than five (5) years old <br /> and/or we do not have a record of the system= <br /> <br /> a. It will be necessary to have the septic tank <br /> pumped <br /> b. Have a DEQ licensed septic tank pumper complete <br /> the form below <br /> e. A field visit will be required by the Sanitarian <br /> to verify the location and condition of the septic <br /> system <br /> do If you have proof that your septic tank has been <br /> pumped within the last five (5) years, sections a <br /> and b above will not be required. Provide <br /> verification cf pumping (receipt from pumper) to <br /> this office. <br /> <br />A~PROXIMATE SIZE OF S~PTIC TANK~ [~ GALLONS <br />IS TANK IN GOOD CONDITION? YES: /' NO= <br />ARE BAFPL~S OR ELBOWS IN PLACe? YES:/ NO: <br /> <br />DLAGRAM OF HOUSE AND <br />LOCATION OF TAR/(: <br /> <br />EXAMPLE: <br /> <br />3/82 Rev 10/87 <br /> <br />W <br /> <br /> <br />