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BUILDING INSPECTION <br />3150 L~NCASTER DR NE - SUITE C <br />SALEM OR. 9730S <br />PH# (S03)588-S 142 <br />FAX//(503)S88-7948 <br /> <br />The following requirements apply to the evaluation of an existing on-site sewage system. Please select the appropriate <br />seclion and follow the directions carefully. <br /> <br /> I)[~_[1~:~! ON-SITE SEWAGE SYSTEM <br /> SEPTIC TANK PUMPING AND <br />MAY 1 1 1999 INSPECTION FORM <br />MARION COUNTY <br /> <br />If your sewage system is less than five (5) years old and a Certificate of Satisfactory Completion has been issued for <br />the system, the septic tank does not require pumping at this time. A field inspection will be made of the entire system <br />and a report will be issued. <br /> <br />2 <br /> <br />-. If your sewage'system is more than five (5) years old and the septic tank has not been pumped within the last five (5) <br /> years, follow the directions below. If you have proof that the septic tank has been pumped within the last frye (5) <br /> years, (A) will not be required. <br /> <br /> A. The septic tank must be pumpe'~ by a DEQ licensed septic tank pumPer. . <br />....... B. The septic t, ank ptrmper ~:~mplete ~ie~rorm b~lOW. <br /> C. A field inspection will be required by our on-sita staff to verify the location and condition of the septic system. <br /> <br />.... "- FOR SEPTIC PUMPER USE ONLY ..... <br /> <br />Properly Owner: <br />Septic Tank Material: Concrete /,/' Steel <br /> <br />Is Tank in Good Condition? Yes // No. <br /> <br />Are inlet & outlet fittings in place? Yes / No.. <br />Is disposal field backing into tank?. Yes <br /> <br /> OEO Ucense: <br /> <br /> Size of Tank: /,,,~ <br /> <br /> Other: <br /> <br />__ If No. please explain: <br /> <br />gallons <br /> <br />No ,,/ IfYes, explain: <br /> <br />If an effiqent pump is included as part of the septic system, the dosing tank and pump assembly must be inspected and <br />cleaned when the septic tank is pumped. <br /> <br />DIAGRAM OF HOUSE AND SEPTIC TANK. SHOW DETAIL AND MEASUREMENTS: <br /> <br />S <br /> <br />/G N ATU R-E~C~F- i~U~ p ER <br /> MCTS-SIglREV 4-96 <br /> <br /> <br />