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S,EPTIC ~A~K EVALUATION <br /> <br /> -To Be Completed By Licensed Septic Pumper Only- <br /> -.~,/,/"~ ' ~} ~ _ . .. <br /> ,, ,~. ~ (,%)?. ~< <br />cOMPlY N~E ~I ~ ,~,¢~ % ~'''" -"'" <br />D~Q LZCENS~ NUmBeR.. ",,"* ~ ....... . _ <br /> <br />SEPTIC ~ANK ~TE~I~,~,~ CAPACITY OF TANK <br /> <br />IS TANK IN GOOD CONDITION? __ ?<' YES NO <br /> · '"~" YES NO <br /> <br />ARE BAFFLES AND ELBOWS IN PLACE? <br /> <br />IS DRAINFIELD BACKING UP INTO TANk? YES <br /> <br /> -Diagram Of House A~d Lo~ation Of Tank- <br /> <br />NO <br /> <br />pumped and inspected thi~ ~ptie tank~ as noted above. - <br /> <br /> <br />