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Septic Tank Pumping/Maintenance <br />Droner Inform. _.`. <br />ation. <br />Date: 22 -c, ll <br />Owner: <br />Property Address: <br />Tank Information <br />Phone: 1 /J - C;c-^ <br />Owner's Address (if different) <br />-i <br />Reason for Pumping- <br />❑ Complinace Inspection <br />❑ Holding Tank <br />Maintenance <br />Method of Access: <br />( Manholes <br />❑ inspection Pipe <br />(Bolding tanks only) <br />(Ownees signature re9'd <br />if refusing to allow pumping through maintenance hole) <br />Condition of Tanks: <br />Filter Cleaned <br />Y Baffles good: <br />Y <br />Alarm working: s <br />�o <br />No <br />No <br />N/A <br />N/A <br />NIA <br />Tank Leakage Observed: Above operating depth <br />Below operting depth <br />Gallons Removed: <br />Disposal Method: Municipal: <br />Land Applied: ❑ <br />Safety Concerns: <br />Recommended Repairs: <br />Comments: <br />Yesll (repairs recommended) <br />Yes/llo (failing to protect groundwater) <br />tank <br />Total <br />Location: Watertown Wastewater Facili <br />Location: <br />1 hereby certifi, that I have completed this work in accordance with AIPV 7083.0770 and any local requirements. <br />No determination or guarantee offuture system f?erfomance has been nor can be made, <br />Chip's Septic Service, LLC & SSTS <br />Swartzer's Sewer Services _ License <br />-- <br />16762 Babcock Avenue 2Main'taner Signature 42064. <br />Lester Prairie, MN. 55354 <br />(952) 200-3176 <br />ciiipseptic@ginail.com <br />revised 3/2025 <br />