Laserfiche WebLink
Pump and Alarm Verification Form <br />Site Address: ____2700 White Oaks Cirlce, Orono ________________________________________ <br />Company Name: __Kloeppner Services & Design_________________ License #: L4043 <br />1. That a representative or I of my company has verified that the Indoor or Outdoor Pump Alarm <br />sounded by lifting the float switch and the alarm light is on and that the pump was tested with <br />the float switch. <br />2. If applicable, that myself or a representative of my company has verified that the Indoor or <br />Outdoor Filter Alarm sounded by lifting the float switch and the alarm light is on. <br />Date: October 14th, 2023 <br />Print Name: Jesse Kloeppner <br />Signed: <br />Please return a copy of this form to: <br />chris@midwestsewer.com <br />Final Inspection and certificate of compliance cannot be issued until this form is received.