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f <br /> C��6(p°S��p��6����alo��o L�d� <br /> �fl�B�$���u�c�9�a����r�� f����� <br /> Date Serviced• �(�/ZZ�/�. Driver• ���' <br /> Residential � Commercial 5tart: Finish • <br /> Type of Service: Regular Allaintenance: 'Y Emergency <br /> f y/►.�cc. ?.y�cvfi. <br /> IVame: Phone: <br /> Address: � S�y � S•x!'� ��- � City,State,Zip: /��t� � /�� S�3 s� <br /> Gallon Pumped: Tank#1:- C7v Tank#2: !0� Pump Tank• � TofaL• ZsT�1 <br /> Access used for pumping: B�o9 and�i��(Explanation): <br /> Tank Condition:_�c�o°-� Evidence of problems: �� <br /> Comments- s�.k-- �/K�/.� C•�l � Z'�. �cv� Ca�v-� � <br /> /'/�seccf Ti�s �./c a�- �ks �ta� �d !�o t�y� �f C�c Ls G.�d <br /> fy � /'Do fs — <br /> Disposal Location: ����'b"v^ — <br /> Waste t,ype• orse�s4i IF8o0dBn��aue�C <br /> Next recommended pumping date: 3 <br /> C9�ip'�Se��c Ser�ri�,L�� . <br /> Designs, Inspections& Maintenance Bill'ing�Information: <br /> Pernel "Chip" Hentges P�P�g' <br /> 16762 Babcock Avenue ��•� y°~" Exposing Manholes <br /> Excessive Distance <br /> _ester Prairie, M1V. 55354 Excessive Grade <br /> 4�952.200.3176 Materials: <br /> �hipseptic@gmail.com � Labor: <br /> o Ob4 �� <br /> ViPCA Ucense N . 2 <br /> 'I'otal Due: <br /> �e CC��� �ie��e1fo�?'�u� <br />