HomeMy WebLinkAbout440 Stubbs Bay Road North - Septic Pumping ReportSeptic Tank Pump ing/Maintenance
Owner Information
Date: ? - 6 _ 25' Phone: 4�42-,&tZ - !Yf2yG
Owner: 1-e � CAL + l�-�c] Email:
Property Address: Owner's Address (if different)
VYo 5�wbh5 �� Rd
—r-xbh10 MN Knl cl
Tank Information
Reason for Pumping: '0 Complinace Inspection ❑ Holding Tank ❑ Maintenance
Method of Access: 0 Manholes ❑ Inspection Pipe (holding tanks only)
(Owner's signature req'd if refusing to allow pumping through maintenance hole)
Condition of Tanks:
Filter Cleaned XX Baffles good: Alarm working: Vs
No No No
N/A N/A N/A
Tank Leakage Observed: Above operating depth
Below operting depth
Gallons Removed:
#1 / Uv #2 / oU #3 #4
Disposal Method.: Municipal: Q
Land Applied: ❑
Safety Concerns:
lRecommended Repairs:
IComments:
Yesy (repairs recommended)
Yes/o (failing to protect groundwater)
tank
Total
Location: Watertown Wastewater Facil
Location:
1 hereby certify that 1 have completed this work in accordance with MN 7083.0770 and any local requirements.
No determination or guarantee of future system verfomance has been nor can be made.
Chip's Septic Service, LLC & SSTS
Swartzer's Sewer Services License
16762 Babcock Avenue Maintaner Signature #2064
Lester Prairie, MN. 55354
(952) 200-3176
chipseptic@tzmaii.com
tzmail.com
revised 312025