HomeMy WebLinkAbout05-22-2021 Septic Pumping ReportDate:
Owner:
Property address:
Information
21-
a-� phone#:
d
Owners address: (if different)
--
—' Tanis InfCorrmuatam�n
Reason for p umjphRgg
C] compliance inspection ❑
holding tank EF°�' a'ir tenance
I`Uthool of acdesso
C] manholes ❑
inspection pipe (holding tanks only)
(owner signature req'd if refusing to allow pumping through maintenance hole)
CCon rdi lion of taus =.
Ater cleaned: files
baffles good: Yes
alarm working: files
No
No
No
n/a
n/a
n1a
Tnnh l nWage nP®scr<ved-.
above operating depth:
Yes No (repairs recommended)
below operating depth:
_Yes No (failing to protect groundwater)
Gallons removed-,
#ll �'f " #2 /� L, �;' �
43 _ 44 pump tank A&4:5z-�' _ total
may`
Bisp®sal Me lnodl-
municipal [11--�
Location:
land apply ❑
Location:
�a�cety c®rnc�u�r�so
Recommended rrcelAanlQw-
CComrrmcents: �
I hereby certify that I have completed this work in accordance with AIN 70133.0770 and any local requirements.
r3yaity tion or guarantee offuture system performance has been nor can be made.
Chip's Septic Service LLC SSTS :License
Maintairibr signature 16762 Babcock Mehue #2064
Lester Prairie, M.N. 55354
(952) 200-3176