Loading...
HomeMy WebLinkAbout08-08-22 Septic Maintenance InspectionSeptic Tank Pumping; / Maintenance Owner Information Tank Information / Date: , ��� ZQ�Z Gcw�GS! i Reason for Pumping: Owner: / /.i,�-G / ,�,H �S Phone#: A 3 — zzz — _ Property address: Qwaers address: (ifdifrerit) 3--lm--anholes ❑ inspection pipe (holding tanks only) (owner signature re(I'd if refusing to allow pumping through maintei ance hole) 1 he y certa ,t I have completed this work in accordance with MN 7083.0770 and any local requirements. No eterminatio or gitarantee of fiture system performance has been nor can be made. _ Chip's Septic Service, LLC SSTS Lice Maintainer signature 16762 Babcock Avenue #2064 Lester Prairie, MN. 55354 (952) 200-3176 Tank Information Reason for Pumping: ❑ compliance inspection ❑ holding tank [LI—iT aintenance Method of access: 3--lm--anholes ❑ inspection pipe (holding tanks only) (owner signature re(I'd if refusing to allow pumping through maintei ance hole) Condition of tanks: filter cleaned: Yes baffles good: Ialarm working: No 0 0 U n/a n/a Tank leakage observed: above operating depth: _des (repairs recommended) below operating depth: Yes L5--> (failing to protect groun(water) Gallons removed: 41 2-C�O o #2 l © 0 d #3 —#4 pump tank tl 0 6,3 total VI tl _ Disposal method: municipal E� location: _ land apply ❑ location: _ Safety concerns: s: 'c &Z Comments: p 1 he y certa ,t I have completed this work in accordance with MN 7083.0770 and any local requirements. No eterminatio or gitarantee of fiture system performance has been nor can be made. _ Chip's Septic Service, LLC SSTS Lice Maintainer signature 16762 Babcock Avenue #2064 Lester Prairie, MN. 55354 (952) 200-3176