Laserfiche WebLink
11:18 mM STAYTON ~EPTIC ~ CON~T. ~8~769S892 <br /> <br />SEPTtC ~A.NK PUN~ING ~ INSPL. C~]~ON FORM <br /> <br /> The following requimemente apply to the evaluation of an existing on-site <br /> ~ewag~ system, please select the appropriate ~ection and follow the directions <br /> carefully. <br /> <br /> i. I~ you~ s~wa~e system is less than ~lye {5) year~ old and a Certificate <br /> of Satisfactory Completion has been issued for the system, the septic <br /> tank does not re~i~e pumpiRg at this time. <br /> Authorization Notices do hot require a field inspection of the <br /> system. A re~rt can ~ i~s~ed based on a review of our files. <br /> Existing System Evaluation~ ~ re. ire a field inspection of the <br /> eot&re system and a re~rt will be i~sued. <br /> <br /> ~f your sewage system is ~Qre than five (5) years old a~d the septic <br /> tank has not been pureed within th~ last five (5) years, ~ol~ow the <br /> directions below. If you have proof tha~ the septic tank has bee~ pumped <br /> wi%bin the last five (5) years, section (a) will not be required. <br /> The septic tank must be pum~d by a D.E.Q. licensed septic tank <br /> pumper. <br /> b. The septic tank pumper must complete ~he form below. <br /> c. AuthorLzation Notices and ~xisting System ~va~uations require a <br /> field inspect&on to verify the location and condition of <br /> septic <br /> <br /> S~on/Mill f~t~e~t ~1~ use <br />cOMPly N~: ~ptic S~ice~ D.~.Q. L~C~NS~ ~: 349~6 <br />PROPRRTY OWNER: Santiam Homes <br />PROPERTY ~D~SS: 11373 Mill Creek ROad, SE <br /> · - Aumsvilleri,Ore-On 973~5 <br /> <br />APPROXI~TE SIZE OF TANK: 1000 .gallons <br /> <br />SEPTIC <br /> ~T~RlaL: <br /> <br />ARE INLET & OUTLET ~TTINGS IN PLACE? Yes X ; No~ <br /> <br /> ~f ~ea", explain: AT TIME OF PUMPING, WATER LEVEL IN TANK TOO HIGH <br /> <br />DIAG~ OF HOUSE ~D SEPTIC T~K: (shew detail wi~h measurements) <br /> <br /> March 31, 1994 <br />DATE OF PUMPING <br /> <br /> MCi5-SI9 <br /> <br /> <br />