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Marion County s~PTxc m~ F~I~ ~ INSPECTION FORM <br /> <br /> The following requirement~ apply to ~he evaluation of an e~isting on-site <br /> sewage system. Please select the appropriate section and follow the directions <br /> carefully. <br /> <br />If your sewage system is less than five (5) years old and a <br />Certificate of Satisfactory Completion has been issued for the <br />system, the septic tank does not require pumping at this time, A <br />field inspection will be made of the entire system and a report <br />will be issued. <br /> <br />If your sewage system is more than five (5) years old and the <br />septic tank has not been pumped within the last five (5) years, <br />follow the directions below. If you have p~oof that the septic <br />tank has been pumped within the last five (5) years, sections <br />and (b) will not be required. <br />a. The septic tank must be pumped by a D.E.Q. licensed septic <br /> tank pumper. <br />b. The septic tank pumper must complete the form below. <br />c. A field inspection will be required by our on-site staff to <br /> verify the location and condition of the septic system. <br /> <br />*for septic pumper use only* <br />(please print) <br /> <br />PROPERTY OWNSR;__/~~ <br />PROPERTY D RESS: <br /> <br />APPROXIMAT~ SIZE OF TANK: <br /> <br />SEPTIC TANK MATERIAL: Concrete <br />IS TANK IN GOOD CONDITION? ............. Yes ~ <br /> <br /> .gallons <br />Steel~; Other~ <br /> <br /> __; No <br /> <br /> If "No", explain: <br /> <br />ARE INLET & OUTLET FITTINGS IN PLACE? .. Yes ....~ ; NO <br />IS DISPOSAL FIELD BACKING INTO TANK? ... Yes ; NO ~ <br /> <br />If "Yes"~ explain: <br /> <br />DIAG~ OF EOUS~ AND SEPTIC <br /> <br /> N <br /> <br />(show detail with measurements) <br /> <br />MCIS-Sl9 [.503) 588-5')47 Senator Building, 2nd Floor <br />RE'V 10-92 220 High St. NE ' Salem, OR 97301.36?0 <br /> <br />$ I~NATURE 0~ <br /> <br /> <br />