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Nov 11 2016 09:08AM HP FaxRusty Olson 7634988290 page 5 <br /> Pumping Report Sewer Services <br /> (Midwest Trenchless,�Swedlund/SullivaniThaemert) <br /> Date Serviced: � - ��" �� Driver's Name: <br /> Residential: Gommercial: Start: Finish: <br /> Type of Service: Regular Maintenance: Emergency; <br /> Name: �:�2 . �,,! <br /> Address: �9�,() ���_ l�c�,n,,e City ��'� <br /> Gallons Pumped: Tank#1,,2.5C� Tank #2 �25C� Pump Tank .�40 Total dQ+U <br /> Access Used for Pumping: anhole Standpipe (Explanation): <br /> Tank Condition: �K_ Evidence of Problems: ��n� _ <br /> Comments: <br /> Filter: Yes/� Type of System: �i� <br /> Disposal Location: Chanhassen Blue Lake LeSueur VVatertown � <br /> VVaste Type: Comrnercial Waste mestic Waste Holdin�Tank <br /> Ncxt Recommended Pumping Date: ��-}�j�' � �6 __ _ _ <br /> Sephc tanks should be pumped every 1 to 3 years. Billing Information <br /> R�Iany differertt variables determine f�ow ofte� pumping(fust 1D00 ga(.)� �$� <br /> a ta�k needs pumping: Additional�allons(36s.00�r i000 e�.�: (,�] <br /> o Type and age of system Exposing Manho(es�e"decp or ksa no charge): <br /> ❑ Number of people in the ltouse Excessive Distance trn�re�nan�zo�}: ,,,,��______ <br /> o Garbage d�sposal Excessive Grade�more cn�zo�m����>: <br /> o Ta�k h�s'tory Riser: <br /> New Gover: <br /> PUMP REPLACEMENTS Matenals: <br /> DESIGNS & INSPECTIONS permit: ��� � <br /> REPAIRS & NEW INSTALLATIONS Payment Method: Totai Due: � <br /> None -Cash -Check {# ) <br /> Sta1e Certifaed cre�ut cara= <br /> T��pe # Eap. <br /> 25648 200te Sl•Belle Plaine. MN 56011 .952-873-3292 <br />