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Sewer Services Inc. <br />r <br />Date Serviced: �(n <br />Scheduled Maintenance: <br />Pumping Report <br />,� Lic:2502 <br />Driver: 'v' <br />Emergency Services: <br />--------------------------- <br />Name: <br />Address: V; <br />,.. <br />Did you measure the accumulation of scum and sludge? <br />Type; <br />Commercial <br />Start time: -7: 1 <br />Stop time: 50 <br />Phone: <br />City: Qy <br />Yes No, pumped regardless <br />Tank 1Tank <br />2 Tank 3 <br />Tank 4 <br />Pretreatment P mp TaQk <br />Gallons Billed`C10'3 <br />Scum ti <br />Sludge <br />%full <br />Operating Depth; <br />. <br />Access used <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 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: 1A i �k <br />Tank Type -Precast - Block - Concrete - Plastic - Other <br />Filter: Yes No—,. --Type of system: Mound - Gravity - Holding Tank - Elevated Trench/Bed <br />Type of wast' : DomescHolding <br />Are tanks leaking above or below flow line? Yes o If yes, where: <br />Did you observe sewage discharging onto the ground surfac <br />Pump Size:'(; I Electrical condition: <br />Are all of the covers securely replaced�Y s No, <br />Safety concerns: <br />Disposal site: <br />Yes, <br />Next recommended pumping: PQA_ 2,r)ra Length of hose required: <br />Comments/Troubleshooting/Repairs: <br />Location of tanks in yard: <br />Sewer Services Inc. 25648 200th Street - Belle Plaine, MN 56011- 952-873-3292 <br />