HomeMy WebLinkAbout2023 11 03 Sewer ServicePumping Report
Lic:2502Sewer Services lnc.
Date Serviced:
Scheduled Maintenance:Emergency Services:
Driver:
Start time:
Type: Residential Commercial
Stop time
Address
Did you measure the accumulation of scum and sludge?Yes No, pumped regardless
Phone
City:
Tank 1 Tank 2 Tank 3 Tank 4 Pretreatment Pump Tank
Gallons Billed
Scum
Sludge
% full
Operating Depth
Access used
Depth to lid
|,refusetoallowtheremovalofthesolidsandliquidsthrough
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 Minn, R. 7080.2450 and 7082.0600
Owner's Signature:
Tank Type - Precast - Block - Concrete - Plastic - Other
Filter: Yes No Type of system: tr/ound - Gravity - Holding Tank - Elevated Trench/Bed
Type of waste: Domestic - Holding
Are tanks leaking above or below flow line? Yes No lf yes, where:
Did you observe sewage discharging onto the ground surface? No Yes,
Pump Size: Electrical condition:
Are all of the covers securely replaced? Yes No,
Safety concerns:
Disposal site:
Next recommended pumping:Length of hose required
Co m ments/Trou bleshooti ng/Repai rs:
Location of tanks in yard
Sewer Services lnc. 25548 200th Street - Belle Plaine, MN 55011 '952-873-3292
Septic tunks should be pamped every I to 3 years.
Muny diffirent vurisbles determine how often
u tunk needs pamping:
Billins Information
Pumping (first 1000 gal.)
Additional gallons :
Name:
|
-,
refuse 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 Minn. R. 7080,2450 and 7082'0600
Owner's Signature:
Tank Type - Precast - Block - Concrete -Plastic - Other
Filter: Yes No Type of system: Mound - Gravity - Holding Tank Elevated Trench/Bed
Type of waste: Domestic - Holding
Are tanks leaking above or below flow line? Yes No lf yes, where:
Did you observe sewage discharging onto the ground surface? No Yes,
Electrical condition:Pump Size:
Are all of the covers securely replaced? Yes No,
Safety concerns:
Next recommended um Length of hose required
ro u b I es hooti n g/Re Pa i rs :Comments/T
Location of tanks in Yard:
Sewer Services lnc. 25648 2OOth Street - Belle Plaine, MN 56011 '952-873'3292
Septic tunks should be pumped evety 1 to 3 yesrs'
Muny dffirent vuriubles determine how often
u tsnk needs Pumqing:
tr Type und uge of sYstem
tr Number of PeoPle in the house
tr Gurbage disPosul
tr Tunk history
PUMP REPLACEMENTS,
INSPECTIONS & REPAIR
25648 200th St'Belle Plaine, MN 56011 '952-873-3292
State Certified.
Billins Information
Exposing Manholes (l2" deep or less no charge)
Excessive Distance (more than 120')l
Excessive Grade (more than 20'total lift)i
None Cash - Check
-(#
Pumping (first 1000 gal.)
Additional gallons :
Servicing Pump Tank
Filing Fee Fuel Surcharge
Payment Method:Total Due:
Emergency Charge:
Materials:
Labor:
Permit
Disposal site:
)