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5%872/~'P872 pOLYF'AK (5~ <br /> <br /> CARBONLESS SPEEDISE7 <br /> ~ below· <br /> <br /> field inspection to verify the location and condition of the <br /> septic system. <br /> <br />COMPANY NA24E: SEPTIC SERVICES D.m.Q. LICFNSE #; 34916 <br />PROPERTY OWNER: Karen Clark <br />PROPERTY ADDRESS: 225 South Patt~n Street <br /> <br /> __Detroit, Oregon <br /> <br />APPROXIMATE S~Z~ OF TANK: 1000 <br /> <br />SEPTIC TANK MATERIAL: Concrete X ; S~eel__ <br /> <br />IS TANK IN GOOD CONDITION? .......... .... Yes__ <br /> <br /> If "No", explain: <br /> <br />ARE INLET & OUTLET PITTINGS IN PLACE] .. Yes <br /> <br />IS DISPOSAL FIELD BACKING INTO TANK? <br /> <br />DIAGR2~M OF HOUSE ~ND SEPTIC TANK: <br /> <br /> gallons <br /> ; Other <br /> <br />X ; No__ <br /> <br />BUILDING iNSPECTION <br /> <br />pole <br /> <br /> X ; No__ <br /> ·.. Yes ; No X <br /> <br />:: Lid is good but has broken handle <br /> <br />ow detail with measurements) <br /> <br />[503) 588-5147 $¢n~o~ t~vildin~ <br />,,,~ ($03} $88-7948 2Z0 ~iSh St. N[ · S.~le,~. O~ <br /> <br />_~9/14/93 <br />DATE OF PUMPING <br /> <br />SIGN~TUR~ OF PUMPER <br /> <br />~CIS-$] <br />R~V 1/' <br /> <br /> <br />