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Pumping Report <br /> Sewer Services Inc. Lic: 2502 <br /> Date Serviced:9 7—c)-0 Driver: J U,S 7l yL Type: lesidential Commercial <br /> Scheduled Maintenance:`. Emergency Services: Start time: O-- <br /> Stop time: <br /> Name: DA-10. , Phone: <br /> Address: 1 osc ci, \10 lam S City: 1444 7.4M <br /> Did you measure the accumulation of scum and sludge? Yes No •umped regardless <br /> Tank 1 Tank 2 Tank 3 Tank 4 Pretreatment Pump Tank <br /> Gallons Billed /OOQ /000 <br /> Scum <br /> Sludge <br /> full <br /> Operating Depth <br /> Access used " 7 H 04 ti <br /> Depth to lid , I 1VOIA 1 Mat <br /> I , refuse to allow the removal of the solids and liquids through <br /> the maintenance hole. I understand that removal of solids and liquids through other access <br /> points is not considered a compliant method of solids removal and does not fulfill the solids <br /> removal requirements of Minn. R. 7080.2450 and 7082.0600 <br /> Owner's Signature: <br /> Tank Type - Pr cast - Block Concrete Plastic - Other <br /> Filter: Yes (. ' Type of system: Mound - cl= Holding Tank - Elevated Trench/Bed <br /> Type of waste: IDomesti Holding <br /> Are tanks leaking above or below flow line? Yes No If yes, where: <br /> Did you observe sewage discharging onto the ground surface. No Yes, <br /> Pump Size: 1\0 Electrical condition: 0V/A <br /> Are all of the covers securely replaced? Yes No, <br /> Safety concerns: /s\V ( <br /> Disposal site: DuA-kr -Dj.t- <br /> Next recommended pumping: 3 jS Length of hose required: 0- ©y <br /> Comments/Troubleshooting/Repairs: Dumped ,-7A11✓kf <br /> Location of tanks in yard: FrOti*yoed 8.1/ brt L+LV r9 <br /> Sewer Services Inc. 25648 200th Street - Belle Plaine, MN 56011 - 952-873-3292 <br /> Septic tanks should be pumped every 1 to 3 years. — Billing Information <br /> Many different variables determine how often Pumping (first 1000 gal.): , '„ gyp- Q <br /> a tank needs pumping: Additional gallons ($115.00 per 1000 gal.): S;. <br /> Servicing Pump Tank($55.00): <br /> ❑ Type and age of system Exposing Manholes (12"deep or less no charge): <br /> ❑ Number of people in the house Excessive Distance (more than 120'): <br /> ❑ Garbage disposal Excessive Grade (more than 20'total lift): <br /> ❑ Tank history Riser: <br /> Emergency Charge: <br /> PUMP REPLACEMENTS, Materials: <br /> INSPECTIONS & REPAIR Labor: <br /> Permit: _ <br /> i n Fee $5.0 ,._ uel Surchar e $5.00 ' <br /> >------- State Certified Payment Method: Total Due: <br /> 200th <br /> None - Cash - Check (# ) <br /> 25648 200 St • Belle Plaine, MN 56011 • 952-873-3292 <br />