Action Center / Pump & Haul Application / Morgan County, Indiana

Pump & Haul Application

Full Name of Applicant*

Address*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Phone Number*

Phone Area Code-Phone 3-Phone 4 ext Extension

Please Do Not Complete The Following Field

Email*

Septic Permit Number*

Pump & Haul Contractor*

Health Department Approval

EHS Signature

Date of EHS Approval

The home located at the above address is approved to go on pump & haul. We have inspected the tank but the installation of the onsite sewage system is delayed until the soil is appropriately dry.

* This is a conditional agreement. If the homeowner is found to be in violation of environmental codes or not using a licensed pump & haul contractor, the Health Department reserves the right to void this agreement. *

Pump & Haul Application

Pump & Haul Application

Health Department Approval

*** This is a conditional agreement. If the homeowner is found to be in violation of environmental codes or not using a licensed pump & haul contractor, the Health Department reserves the right to void this agreement. ***

Dialog Title

* This is a conditional agreement. If the homeowner is found to be in violation of environmental codes or not using a licensed pump & haul contractor, the Health Department reserves the right to void this agreement. *