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2640 Fox Street - 04-117-23-42-0008
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2024 Pumping Report
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Last modified
5/13/2024 11:57:03 AM
Creation date
5/13/2024 11:56:56 AM
Metadata
Fields
Template:
x Address Old
House Number
2640
Street Name
Fox
Street Type
Street
Address
2640 Fox Street
Document Type
Septic
PIN
0411723420008
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Pumping Report <br />Sewer Services Inc. Lic: 2502 _ <br />Date Serviced: ab Driver �� Ylc�(e t{ Type Residentia Commercial <br />Scheduled Maintenance: / Emergency Services: start time: J / 2 <br />Stoo time: <br />Yk <br />Address: a b 0 -0 S I- . <br />Did you measure the accumulation of scum and sludge? <br />Phone: <br />Cit :'' rr7r1 <br />No, pumped regardless <br />Tank 1 ITank 2 <br />Tank 3 <br />Tank 4 <br />Pretreatment <br />Pump Tank <br />Gallons Billed 00 040 <br />�Jrcec <br />Scum i <br />Sludge IA. <br />% full 7' . <br />Operating Depth i <br />Access used <br />Depth to lid (G <br />7 <br />1 refuse to allow the removal of the solids and liquids through <br />the maintenance hole. I understand that removal of solids and liquids through other access <br />points is not considered a compliant method of solids removal and does not fulfill the solids <br />removal requirements of Minn. R. 7080.2450 and 7082.0600 <br />Owner's Signature: <br />Tank Type ,�r-e�-e�as Block oncret Plastic - Other <br />F•lt r Ye. C 0 Type of system 4ow ce Gravity - Holding Tank • Elevated Trench/Bed <br />Type of waste- omeJ Holding <br />Are tanks leaking above or below flow line? Yes No If yes, where: <br />Did you obsennrve sewage discharging to the ground surface fo Yes, <br />Pump Size: r� s 1 Electrical_ ondition: Op <br />Are all of the covers securely replaced? a No, <br />Safety concerns: 0 (AC 1 CtiCQ e 0 <br />D"ispp <br />osall site: U W <br />Next recommended pumping J,l4 n • Length of hose required: f <br />Comments/ 1 rour <br />f'• �r't �„�� <br />t+ Location of tanks <br />Iczc <br />. Pekr-w—i- 4owef 5 i rl <br />Sewer Services Inc. 25648 2UOth Street - Belle Plaine, MN 56011- 952-873-3292 <br />Septic tanks shordd be pumped every I to 3 years. <br />Many different variables determine how often <br />a tank needs pumping: <br />u Type and age of system <br />u Number of people in the house <br />u Garbage disposal <br />:r Tank history <br />PUMP REPLACEMENTS, <br />INSPECTIONS & REPAIR <br />State Certified <br />25648 200'h St • Belle Plaine, MN 56011 1952-873-3242 <br />Billine Information <br />of <br />Pumping (first 1000 gall.. Q. <br />Additional gallons : 94:51, <br />Servicing Pump Tank :'�'8 . e <br />Exposing Manholes S 12" dccp or kss no uhargcj: ti <br />Excessive Distance I.— th-12o•1: <br />Excessive Grade (mom imn 2o•„ ai imm: <br />Riser: <br />Emergency Charge: <br />Materials: <br />Labor: E Ca55i Sc <br />Permit: <br />Filing Fee , �� Fuel Surcharge 1 i. <br />Payment Method: Total Due: $`a2 • 't <br />None - Cash _- Check (4 ) <br />
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