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1000 Cox Farm Road - 27-118-23-32-0018
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Compliance Inspection Form
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Last modified
7/16/2024 3:34:31 PM
Creation date
7/16/2024 3:33:58 PM
Metadata
Fields
Template:
x Address Old
House Number
1000
Street Name
Cox Farm Road
Address
1000 Cox Farm Road
Document Type
Septic
PIN
27-118-23-32-0018
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Chip's Septic Service, LLC <br />Maintenance/pumping Report <br />Qate_Servieed; __ —_���^- -- -- - - .. —Driver:—_ 6* -- <br />Residential____ _'�. Commercial. Start:_ �_.1=inish_ <br />Type of Service: Regular Maintenance: - _- -----Emergency:-. - -- <br />Name:.. Vu,o �A?,Uw. — Phone:-_ - -- --- — <br />LeFI <br />Address:-&o 6o�FAP_&JW - -. City,State, Zip:----U�a�I' _ S`i✓a <br />Gallon Pumped: Tank #1:_/SO!0 - Tank #2:--/- _ .-_ Pump Tank:_ Zoe Total:. 2•5-00 <br />Access used for pumping: an Standpipe (Explanation):- - <br />Tank Condition:_- lwa( _ Evidence of problems: . <br />Comments:_ �c� s�,... E• _�d—'-._—.�eu�ic�-lus .__� .. _ <br />Disposal Location:!" <br />Waste typ • ornestic Holding Tank <br />Next recommended pumping date: <br />Chip's Septic Service, LLC <br />Designs, Inspections & Maintenance <br />Pernel "Chip" Hentges <br />16762 Babcock Avenue <br />Lester Prairie, MN. 55354 <br />#952.200.3176 <br />chipseptic@gmail,com <br />MPCA License No. 2064 <br />Bihina 111formation <br />Pumping: <br />Exposing Manholes <br />Excessive Distance <br />t:::cessive Grade _ <br />Materials:--- <br />Labor:— <br />Total Due: <br />"yhe Guys in the Big Yellow Trurk" <br />
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