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_l~E~lMar, ion <br /> -~ O~o~ ss~c ~ ~o ~ ~s~s~ou <br /> The folloWl~q~ '~" 'i~emente apply to the evaluation, of an .~ng on-si~e <br /> sewage systs~,; ~s~ select the appropriate section and fol~ow the dlrec~ions <br /> carefully, <br /> <br />[¢ you~ sewage system is Less than five (5} years (lid and a <br />Certificate of Satisfactory Completion has been issued for Ebe <br />Sy,~m~ the septic tank does not rec~ire pumping a% this time. A <br />¢lm~d inspection will be made of the entire system and s report <br />Wkl'~ be issued, <br /> <br />2, J[ your sewage system is more than five (5) years old and the <br /> ~sp~ic tank hms not beep pumped within tbs last five (5) years, <br /> f~ow ~h~ direr%ions below. If you have proof tha~ the septic <br /> ~k has been pumped within the last ~ive (5) years, sections <br /> ~ (~).will no~ bm required. <br /> a, The septic tank m~e¢ be pumped bY a D,E,Q. licensed septic <br /> ~ank pumper. <br /> b, The septic tank pumper must complete :he form below'. <br /> c. A 'field inspection will be required by our on-site staf~ to <br /> verify the location and condition of ~hs septic system. <br /> <br /> *for septic pumper use only* <br /> (please print) <br /> <br />APPROXI~T~ ~ OF TANK: <br /> <br />SEPTIC TA~ ~TERIAL: Concrete ,~l Steel ; Other ,, <br />IS T~K IN G~D CONDITION? ............. Yes~ ; No,,, <br /> <br /> If "No", explain: <br /> <br />A~LE INLET & OUTL~T FITTINGS IN PLACE? ., <br />IS DIS~O~ ~I~LD ~ACKIN~ IN~O TANK? ... <br /> <br /> If "~S~", explain: <br /> <br />Yes ; No. <br />Yea ; No.~ <br /> <br />MC15-S19 (5031 .5RB-~147 5~nator 8uiJdln~, ~nd Floor <br /> <br /> DAT~ OF ~.UMPING <br />.~S iCNA'T?~,.~$ ~~.~OF pUH~E~ <br /> <br /> <br />