HomeMy WebLinkAbout01-26-2023 Septic Maintenancesewer Services Inc.
Date Serviced: i ),6 - a S Driver:
scheduled Maintenance:
T3�3�i�i.3rlwlw
Pumping Report
Lic: 2502
Services
Name: 7 i t
Address: ao5 2
Did you measure the accumulation of scum and sludge?
start time: 5
Stop time: r7 I a
Phone:
City: J r�lJ
Y No, pumped regardless
1refuse to allow the removal of the solids and liquids through
the maintenance hole. I understand that removal of solids and liquids through other access
points is not considered a compliant method of solids removal and does not fulfill the solids
removal requirements of Mine. R. 7080.24S0 and 7082.0600
Owner's Sigr=t _
Tank Typ - Pr Giock - Concret - Plastic - Other
Filter: Yes No Type of system: Mound - Gravity - Holding Tank -Elevated Trenchl6ed
Type of waste:amesti - Holding
Are tanks leaking above or below flow line? Yes No If yes, where:
Did you observe sewage discharging onto the ground surface Yes,
Pump Size: Eledrica condition: o0
Are all of the covers securely replace a No,
Safety concerns: rt r—x
Disposal site. 611A Q L/t
Next recommended pumping: Length of hose required:
Sewer 5,�,vires Inc. 25648 200th Street - Belle Plaine, MN 56011- 952-873-3292
Septic tanks should be pumped every 1 to 3 years.
Many different variables determine how often
a tank needs pumping.
o Type and age of system
❑ Number of people in the house
❑ Garbage disposal
❑ Tank history
PUMP REPLACEMENTS,
INSPECTIONS & REPAIR
State Certirted
25649 200" St • Belle Plaine, MN 56011 •952-873-3292
Mine Information
Pumping (first 1000 gal.):
Additional gallons : 1
Servicing Pump
Exposing Manholes p2" dxP oc less no cha gc):
Excessive Distance tmncemaa 120'}:
Excessive Grade (m— lha 20' mtai lift):
Riser.
Emergency Charge:
Materials:
Labor:
Permit:
Filing Fee 9,e FuelSurchar e
Payment Method: Total Dueg 6 ��
None - Cash - Check _ (# )
Tank 1
Tank 2 Tank 3 Tank 4 Pretreatment
Pump Tank
C Cec
r0perating
Access used
G
1refuse to allow the removal of the solids and liquids through
the maintenance hole. I understand that removal of solids and liquids through other access
points is not considered a compliant method of solids removal and does not fulfill the solids
removal requirements of Mine. R. 7080.24S0 and 7082.0600
Owner's Sigr=t _
Tank Typ - Pr Giock - Concret - Plastic - Other
Filter: Yes No Type of system: Mound - Gravity - Holding Tank -Elevated Trenchl6ed
Type of waste:amesti - Holding
Are tanks leaking above or below flow line? Yes No If yes, where:
Did you observe sewage discharging onto the ground surface Yes,
Pump Size: Eledrica condition: o0
Are all of the covers securely replace a No,
Safety concerns: rt r—x
Disposal site. 611A Q L/t
Next recommended pumping: Length of hose required:
Sewer 5,�,vires Inc. 25648 200th Street - Belle Plaine, MN 56011- 952-873-3292
Septic tanks should be pumped every 1 to 3 years.
Many different variables determine how often
a tank needs pumping.
o Type and age of system
❑ Number of people in the house
❑ Garbage disposal
❑ Tank history
PUMP REPLACEMENTS,
INSPECTIONS & REPAIR
State Certirted
25649 200" St • Belle Plaine, MN 56011 •952-873-3292
Mine Information
Pumping (first 1000 gal.):
Additional gallons : 1
Servicing Pump
Exposing Manholes p2" dxP oc less no cha gc):
Excessive Distance tmncemaa 120'}:
Excessive Grade (m— lha 20' mtai lift):
Riser.
Emergency Charge:
Materials:
Labor:
Permit:
Filing Fee 9,e FuelSurchar e
Payment Method: Total Dueg 6 ��
None - Cash - Check _ (# )