HomeMy WebLinkAbout04-16-2020 Septic Pumping Report001*1 4
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INVOICE—Septic Service Record
Andrew Kleindl L2926
www.'i -excavatio .com
95
,1442-7 9 2 8 2
Date of Service:
Property Owner �_T,
Address: 7cg5
Email Address:
Service Record
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Reason: o tinb Pump Service Call Emergency
Access Used to Remove Septage: aintenance Hole Other
Leaking Observed Yes
Disposal Site atertown Treatment FacilitN�> Blue Lake Other
Concerns
A411
Quantity ,") � cme
Description
Amount
#Gallons #Tanks
Pumping/Disposal
$=�
Repairs—Parts
Septic Compliance Inspection
Gould Pump Replaced PE41 PE51
Effluent Filter Cleaned
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. All &WN %kindi #2926