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of Sati~factory ¢ompl~tion ha= been issued for~he sy~te~, the <br /> <br /> system. A re~ oan be issued ba~ on a ~eview Of our files. <br /> Existinq System Evaluations d~ re~ire a field ins~Ctfon Of the <br /> entire system and a ~e~=~ will be issued. <br /> <br />tank has not been p~d within =h~ last fi~ (5) year~, follow the <br />dir~c=ions ~low. If you have proof that the s~ptic =ank ha~ been pum~d <br />within =h~ last five (S) year~, section {a) will not be <br />a. The ~ep~%c ~a~k must be p~d by a D.B.Q. licensed septic tank <br /> pum~r. <br /> <br /> field inspection to verify th~ location and condition of the <br /> <br />COMPANY NAbi~:__ =S~ptic Services D.~.Q. L~CENSF #:__34916 <br /> <br />PROPERTY oWNER:~ Gloria Johnson <br />PROPERTY ADDRESS: ] ~485 Ja~es .Way <br /> __ Aums~i~le, OregJn 97325 ........ <br />APPROXI~TE ~IZ~ OF TANK:~ ~2q~ ........ gallons <br /> <br />SEPTIC T~K ~TERIAL: Concrete..X .; Stael__~ 0~her_ <br /> <br /> IS TANK IN ~ CONDITION? ............. ' Yes~; No~ <br /> <br /> If "No", e~plain: ............. <br />ARE ZNLET & OUTLET FITTINGS IN <br /> <br />~S D~SPOSAL FIELD BACKING INTO T~K? ... ~es~ _; No X <br /> <br /> If "YES", explain: ..... , ..... <br /> <br />OIAG~ OF ~OUSE ~D SEPTIC T~K= (show detail with measurements) <br /> <br />/~1 qRRo7~4~ 22~ Nigh .~. Nd · Salem, OR 9730%3670 <br /> <br /> 1 0 95 _ , , <br />DATE OF PUN~N~ <br /> <br />~1 5-S 19 <br /> <br /> <br />