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pQMPER FOR/4 <br /> <br />In order to properly evaluate your existing sewage system, the £ollowin~ <br />information will be necessary: <br /> <br /> If your sewage system is less khan five (5) years old, and we have <br /> an approveO record of the system, we can proceed wi~hou~y <br /> <br /> not have a record of am approved installation of %he ~ys%em~- <br /> <br /> If your se~a~e ~ystem i~ mo~e tha ti (~) ye ~ o1~~.~ <br /> been um ed within the last five years: '"&~ ~ ~J~ <br /> <br /> ~ For Septi~ Tank ~r Use ~ly <br /> <br />IS DRAINFXELD ~ACKING UP INTO TANK? -.. YES; UNO <br /> <br /> If yes, explain; ,~ <br />SEPTXC TANK MATERIAL: ConcrEte,, ~/F Ste~l. Other <br /> <br />DIAGRAM OF HOUSE AND <br />LOCAT%ON OF TANK= <br /> <br />example <br /> <br />Rev 7/89 pb <br /> <br />-- $ <br /> <br /> <br />