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Marion <br /> O RE O 0 N ON-SIZE SEWAGE SYSTEM <br /> SEPTIC TA/~ PUMPING AND INSPECTION FOR]4 <br /> <br />The following reepairements apply to the evaluation of an existinq on-site <br />sewage system. Please select the appropriate section and follow the directions <br />carefully. <br /> <br /> 1. If your sewage system is less...than five (5) years old and a Certificate <br /> of Satisfactory Completion has been issued for the system, the ~epti¢ <br /> tank does ~ot require pumping at this time. <br /> a. Authorization Notices do not require a field inspection of the <br /> system, k report can be issued based on a review of our files. <br /> b. Existing System Evaluations d_~o require a field inspection of the <br /> entire ~ystem and a report will be issued. <br /> <br />2. If your sewaqe system is more..than five (5) years old and the septic <br /> tank has not been pumped within the last five (5) years, follow the <br /> directions below. If you have proof that the septic tank has been pumped <br /> within the last five (5) years, section (a) will not be required. <br /> The septic tank must be pumped by a D.E.Q. licensed septic tank <br /> pumper. <br /> b. The septic tank pumper must oomplete the form below. <br /> c.. Autbori=atlon 5~ociccs and Existing System E~aluations require a <br /> field inspection to verify the location add condition of the <br /> septic system. <br /> <br /> Stay,on/Mill City & ~C~v%~P~6~ pumper use only* <br /> 34916 <br /> COMPANY NAME: Septic Services D.E.Q. LICENSE #: <br /> <br />PROPERTY OWNER: Parian Watts <br /> <br />PROPERTY ADDRESS: 10351.Leverman Road <br /> <br /> Aumsville, OR 97325 <br /> <br />APPROXIMATE SIZE OF TANK: 1000 <br /> <br />gallons <br /> <br />SEPTIC TANK MATERIAL= Concre~e__~_; <br /> <br />IS TANK IN GOOD CONDITION? <br /> <br /> If "No", explain= <br /> <br /> X <br />ARE INLET & OUTLET FITTINGS IN PLACE? .. Yes. <br /> <br />IS ~SPOS;kL FIELD SACKING INTO TANK? ... Yes <br /> <br />Steel .... ; Other <br /> <br />; NO <br /> <br />; NO X <br /> <br />DIAGRA34 OF ~OUSE AND SEPTIC TANK: (show detail with measurements) <br /> <br />;03) 588-5147 Senator Buildin8 <br /> <br /> 7130/94 <br /> <br />I*Nf E OF SPE ' <br /> MC15-Si 9 <br /> <br /> <br />