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ri~pn County os-sI~E S~AGE SYS~'~ <br /> <br />The following requirements apply to the evaluation of sn ex/sting on-site <br />sewage system. Pleaee select the appropriate section and follow the directions <br />carefully. <br /> <br />If your sewage system is less than five (5) years old and a <br />~ertificate of Satisfactory Completion has been issued for the <br />system, the septic tank does not require pumping at this time. A <br />field inspection will be made of the entire system and a report <br />.will be issued. <br /> <br />If your sewage system is more than five (5) years old and the <br />septic tank has not' be~n'pumped within the lest five (5} years, <br />follow the directions, below. If you have proof that the septic <br />tank has been pumped within the last five (5} years, sections (a) <br />and (b) will not be required.' <br />a. The septic tank must be pumped by a D.B.Q. licensed septic <br /> tank pumper. <br />b. The septic tank pumper must complete the form below. <br />c. A field inspection will be required'by our on-site staff to <br /> verify the location and condition of the septic system, <br /> <br />*for septic pumper use only* <br />(please print) <br /> <br />APPROXIMATE SiZE OF TANK: /~ <br />SEPTIC TANK MATERIAL: Concretes ; Steel <br /> <br />IS TANK IN GOOD CONDITION? ............. Yes <br /> <br /> If "No", explain: , <br /> <br />ARE INLET & OUTLET FITTINGS IN PLACE? .. Yes <br /> <br />DISPOSAL FIELD BACKING IN~O TANK? ... Yes ; <br /> <br />gallons <br />Otb.r- RECEIVED <br />No <br /> <br />No <br /> <br /> JAN 2 7 1997 <br />MARION COUNTY <br />BUILDING INSPECTION <br /> <br /> If "Yes", explain= <br /> <br />DIAGRAM OF HOUSE AND SEPTIC TANK=. (show detail with measurements) <br /> <br /> N <br /> <br />10-92 ' <br /> <br />Senator Buiidiflg, 2nd Floor <br />220 High St. NE · Salem, OR 97301-3670 <br /> <br />(503) 588-5147 <br /> <br /> <br />