HomeMy WebLinkAbout04-27-2020 Septic Pumping ReportINVOICE -Septic Service Record
Andrew Kleindl L2926
www.jims-excavating.com
(952)-442-9262
Date of Service: �7
Property Owner
Address: �f� (7) ��1'1���i.��' /� kJAvzaA i I4
Email Address:
Service Record
Reason: Ro_ t' e Pump Service Emergency
Access Used to Remove Septage. aintenance Hole > Other
Leaking Observed Ye
Disposal Site Wrtown Treatment Facility , Blue Lake
Concerns
Other
Quantity �� %
Description
Amount
#Gallons #Tank �
Pumping/Disposal
$ 6
Repairs—Parts
e r`
Septic Compliance Inspection
Gould Pump Replaced PE41 PE51
Effluent Filter Cleaned
A Id",
Trip- Labor
TOTAL
If owner refuses to allow SSTS to be pumped through the maintenance hole, sign this statement,
I, refuse to allow the removal of the solids/liquids through the maintenance hole.
Owner's Signature:
Date:
Maintainer Information The work was personally conducted by Andrew Kleindl, of Jim's Excavating.
This report will be filed with your appropriate reporting agency. Typically city or county keeps these
records on file. 11ndjW 7iWn& #2926