Name of farm: Type of system: Age of system: Date Identified Completed Observations of Tank Lid Corrective Date: by Corrective Actions: by Drain field: Condition Condition Action (Initials): (Initials): Completed: Smelly odor, soggy Had it pumped, receipt on file. No risk to 4-26-14 intact intact ABC 5-5-14 ALW ground crops, located well away from growing area. Reviewed by: Title: Date:
Name of farm: Type of system: Age of system: Date: Observations of Drain field: Tank Condition Lid Condition Identified by (Initials): Corrective Actions: Date Corrective Action Completed: Completed by (Initials): 4-26-14 Smelly odor, soggy ground intact intact ABC Had it pumped, receipt on file. No risk to crops, located well away from growing area. 5-5-14 ALW Reviewed by: Title: Date: