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09-28-2021 Septic Pumping Report
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09-28-2021 Septic Pumping Report
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Last modified
8/22/2023 4:20:50 PM
Creation date
10/4/2021 10:27:51 AM
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x Address Old
House Number
930
Street Name
Cox Farm
Street Type
Road
Address
930 Cox Farm Road
Document Type
Septic
PIN
2711823330013
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Sewer Services Inc. <br />Date Serviced: y/ 2 <br />Pumping Report <br />Lic: 2502 <br />Driver: &Juc <br />Type: Residential Commercial <br />Scheduled MaintenanceX Emergency Services: Start time: /; U <br />Stop time: <br />Name: 5 Phone: <br />Address: R,2,0CyX-fj(p M 2/�. �ON� SS2.5(, City: <br />Did you measure the accumulation of scum and sludge? Yes No, pumped regardless <br />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 me hod of solids removal and does not fulfill the solids <br />removal requirements of Minn. R. 702450 and 7082.0600 <br />Owner's Signature: <br />Tank Type - Preec_a_st- Block 'Concrete - Plastic - Other <br />Filter: Yes No Type of system: Mound Gravity - Holding Tank - Elevated Trench/Bed <br />Type of waste: Domestic - 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 <br />Pump Size: Electrical condition: <br />Are all of the covers securely replaced? Yes No, <br />Safety concerns: <br />Yes, <br />Disposal site: LnE'Gib <br />Next recommended pumping: S Length of hose required: <br />Comments/Troubleshooting/Repairs:rLe—W�� k -s <br />Location of tanks in vard:e <br />Tank 1 <br />Tank 2 <br />Tank 3 <br />Tank 4 <br />Pretreatment <br />Pump Tank <br />Gallons Billed <br />( &V -V <br />1 0 -r -V <br />d1 C e <br />Scum <br />Sludge <br />full <br />Operating Depth <br />Access used <br />5 �' <br />Depth to lid <br />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 me hod of solids removal and does not fulfill the solids <br />removal requirements of Minn. R. 702450 and 7082.0600 <br />Owner's Signature: <br />Tank Type - Preec_a_st- Block 'Concrete - Plastic - Other <br />Filter: Yes No Type of system: Mound Gravity - Holding Tank - Elevated Trench/Bed <br />Type of waste: Domestic - 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 <br />Pump Size: Electrical condition: <br />Are all of the covers securely replaced? Yes No, <br />Safety concerns: <br />Yes, <br />Disposal site: LnE'Gib <br />Next recommended pumping: S Length of hose required: <br />Comments/Troubleshooting/Repairs:rLe—W�� k -s <br />Location of tanks in vard:e <br />
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