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Pumping Report <br />Sewer Services Inc. Lic: 2502 <br />Date Serviced: "I ? ! k `1 Driver: I .,l T( ype <br />Scheduled Maintenances Emergency Services: <br />r <br />Name <br />Address: <br />Did you measure the accumulation of scum and sludge? <br />iesidentia.l% Commercial <br />Start time: : o <br />Stop time: <br />Phone: <` <br />City: 1, <br />Yes No, pumped regardless <br />Tank 1 <br />Tank 2 <br />Tank 3 <br />Tank 4 <br />Pretreatment <br />Pump Tank <br />Gallons Billed <br />Scum <br />j t1 <br />Sludge <br />° I <br />full <br />t•.� °,' n <br />Operating Depth <br />Llk I t1 <br />Access used <br />AJ ;-I <br />Depth to lid <br />I , 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: <br />Tank Type (Precast% Block - Concrete)- Plastic - Other <br />Filter: Yes 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`, Yes, <br />Pump Size: f..iC; :;, l i Electrica.l condition: <br />Are all of the covers securely replaced?(Yes` No, <br />Safety concerns: ;�`��'`�Q <br />Disposal site: — <br />Next recommended pumping: Length of hose required: (. ' <br />Comments/Troubles <br />Location of tanks in yard: <br />Sewer Services Inc. 25648 200th Street - Belle Plaine, MN 56011- 952-873-3292 <br />Septic tanks should be pumped every 1 to 3 years. <br />Many different variables determine how often <br />a tank needs pumping: <br />u Type and age of system <br />o Nutnber of people in the house <br />u Garbage disposal <br />u rank history <br />PUMP REPLACEMENTS, <br />INSPECTIONS & REPAIR <br />--Stute Cef•tifed _._� <br />25648 200"' St • Belle Plaine, MN 56011 • 952-873-3292 <br />BillinLy Information I <br />Pumping (first 1000 gal.): <br />Additional gallons : <br />Servicing Pump "rank : _ <br />Exposing Manholes (12"deepurlessnoclmrLel: •--�-� <br />Excessive Distance pnurc than i2o'): <br />Excessive Grade (more than 20' total lilt): <br />Riser: <br />Emergency Charge: —.___... <br />Materials: <br />- <br />--. ------------ -- <br />Permit: _ <br />Filing Fee �1, l9' Fuel Surcharge A—iT. a <br />Payment Method: Total Due: <br />None _ -- Cash — - Check _ - (#. ) <br />