HomeMy WebLinkAbout9.18.23 Septic Pumping ReportSeptic Tank Pumping / Maintenance
Owner Information
Date: Z 3
Owner:_ ",'_ /�/ e; Phone#: Z
Property address: �--�- Owners address: (if different)
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Tank Information
Reason for Pumping: ❑ compliance inspection ❑ holding tank 9 -maintenance
Method of access: manholes ❑ inspection pipe ( holding tanks only)
(owner signature req'd if refusing to allow pumping through maintenance hole)
Condition of tanks:
filter cleaned: <� baffles good: alarm working: (0)
No No No
n/a n/a n/a
Tank leakage observed: above operating depth: Yes o (repairs recommended)
below operating depth: Yes (failing to protect groundwater)
Gallons removed:
#1 160o #2 --� #3 _ #4 pump tank d total ZSa U
Disposal method: municipal location: az� e4 %
I Safety concerns:
/1 m <-
Recommended repairs:
4 dY`'L
I Comments:
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land apply ❑ location:
4
- .s., k4
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1 hereby certify that I have completed this work in accordance with MN 7083.0770 and any local requirements.
No det on or guarantee offuture system performance has been nor can be made.
Chip's Septic Service, LLC _ SSTS License
Maintainer si nature 16762 Babcock Avenue #2064
Lester Prairie, MN. 55354
(952) 200-3176