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SEPTIC TANK EVALUATION <br /> <br />PROPERTY OWNER <br /> <br />ADDRESS/LOCATION OF EVALUATION, <br /> <br />-To Be Completed By Licensed Septic Pumper Only- <br /> <br />IS TANK IN GOOD CONDITION? <br /> <br />ARE BAFFLES AND ELBOWS IN PLACE? <br /> <br />IS DRAINFiELD BACKING UP INTO TANK? <br /> <br />CAPACITY OF TANK ~v GALS. <br /> <br /> ~k.., YES NO <br /> YES Q~ NO <br /> <br />-Diagram of House And Locatloh Of Tank~ <br /> <br />C <br /> <br />I pumped and inspected this septic tank and found conzlitions <br />above as of this date. ' J~ ' l1 ' ~ -//-"- <br />SIGNATURE OF SEPTIC TANK PUMPER /~~ .~~ <br /> <br />as noted <br /> <br /> <br />