HomeMy WebLinkAbout2400 Fox Street Pumping ReportSeptic Tank
Pumping '':
Givner Information
Date: -s/l'! f Zp 2-3
Owner: OSS hT 4Zr w v` Phoneu:
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Property address: Owners address: (if different)
7-Y00 S -r
Tank Information
Reason for Pumping: ❑ compliance inspection D holding tank [tmvintenance
Method of access: D Manholes D inspection pipe (holding tanks only)
(owner signature req'd if refusing to allow pumping through maintenance hole)
Condition of tanks:
filter cleaned: es baffles good: alarm working: �j
OF o NO
n/a n/a n/a
Tank leakage observed: above operating depth: Yes o (repairs recommended)
below operating depth: Yes _ o (failing to protect groundwater)
Gallons removed:
#irju #2 130 V #3 #4 pump tank '%M total 3
Disposal method: municipal C� location: ,7`�'�-•'1
land apply ❑ location:
Safety concerns: //
Recommended repairs:
Commen :
hal'p
-7t- 3 -e " cam., '- Do - ' reurt 0(;r4.
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1 hereby certify that I have completed this work in accordance with MN 7083.0770 and any local requirements.
No or guarantee offitttrre system pe�forntance has been nog- can be made.
Chip's Septic Service, LLC SSTS License
Maintainer signature 16762 Babcock Avenue #2064
Lester Prairie, MN. 55354
(952) 200-3176