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sewage system. ~eag9 sel~c~ the appropriate ~ec~ion and follow the directions <br />carefully. <br /> <br />Certificate of Satisfactory Completion has been issued for =he <br />Ry~tem, the ~eptic tank does no~ require pumping at t~is time. k <br />f~eld £nepection will be made of the entire ~y~=em a~d & report <br />will be issued. <br /> <br />If you= sewage flystem is more than five (5) yearg old and the <br />septic tank his not been pumped within the las~ five (5) years, <br />follow the d£rec~on9 below. If you have p~oof that the septic <br />tank has been pumped wi~ain :he las: five (51 years, sections <br />and (b) will not be recfuired. <br />a, The septic tank must be pumped by a O,~,Q, ILcen~ed meptic <br /> tank pumper, <br /> The ~ep~ic tank pumper must complete the form <br />¢. A field ingpecLLoa will be required by our on-site staff to <br /> <br />,for septic pumper use only* <br /> <br /> Stayton/Mill City and(Please prin:) <br />CO~R~ NAME:. Silverton Septic Services <br />PROPERTY OWNER:__ Alice Morrison <br />PROPERTY ADDR/~$S:~., 15073 Friendly Acres Rd. SE <br /> <br /> Aumsvllle, Ore6on <br /> <br />APPROXIMATE SIZE OF TANK~ ,750 gallons <br />SEPTIC TANK MATERIAL~ Concrete ; Steel. ,X. ; Other. <br />IS TANK IN GOOD CONDITION? ............. Yss, X ; No , <br /> <br />D.E,Q. LICENSE #:34916 <br /> <br />If "No" explain' <br /> <br />MC15-$19 <br /> <br />AR~ INLET & OUTL~T PITTING$ IN PLACE? .. Ye~,SL__; NO <br /> <br />IS DISPOrA/~ FIELD BACKING INTO TANK? ... Yes ; No X <br /> <br /> I~ "Yes", e~p%&in* ....... <br /> <br />DIAG~ OF MOUSE ~D S~TIC T~K: (show 4etail with m~amurements) <br /> <br /> N <br /> <br /> 3/1~/96 _ <br />DATE OF PUMPING <br /> <br /> <br />