HomeMy WebLinkAbout2630 Fox Street - Septic Pumping ReportSeptic Tank Pumping/Maintenance
Owner Information
Date: _, - f - Phone:
Owner: —MC!QL4 Email:
Property Address: L Owner's Address (if different)
�]p
Reason for Pumping:
Method of Access:
(Condition of Tanks:
Filter Cleaned
Leakage Observed:
Gallons Removed:
#1 1yN-V,% #2
(Disposal Method:
(Safety Concerns:
Recommended Repairs:
Comments:
Tank Information
❑ Complinace Inspection ❑ Holding Tank V Maintenance
7— Manholes ❑ Inspection Pipe (holding tanks only)
J (Owner's signature req'd if refusing to allow pumping through maintenance hole)
Yes Baffles good: ec
s Alarm working:
No No
YA N/A N/A
Above operating depth Yes/
,Vo (repairs recommended)
Below operting depth Yes/I�o (failing to protect groundwater)
#3
Municipal:
Land Applied:
#4
tank
Total �0
Q Location: Watertown Wastewater
❑ Location:
I hereby certify that I have completed this work in accordance with AN 7083.0770 and any local requirements.
No determination or guarantee offuture s mane 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
chipseptic9amail.com
revised 312025
Septic rank Pumping/Alaintenance
Owner Information 0IzzSlu
Date: Phone:
Owner: - R� _�j i� -AA:, Sn�fP. Email:
Property Address: Owner's Address (if different)
(o S4
Reason for Pumping:
of Access:
Condition of Tanks:
Filter Cleaned
Tank Information
Q Complinace Inspection 0 Holding Tank Maintenance
0 Manholes O Inspection Pipe (holding tanks only)
(Owner's signature req'd if refusing to allow pumping through maintenance hole)
fya Baffles good: Alarm working: f S
No o No
N/A N/A N/A
Tank Leakage Observed: Above operating depth
Below operting depth
Gallons Removed:
# 1 %#2 0` #3 #4
Disposal Method: Municipal: Q
Land Applied: 0
Safety Concerns:
Recommended Repairs:
Comments:
Yes (repairs recommended)
Ye o (failing to protect groundwater)
tank
Total
Location: Watertown Wastewater Facili
Location:
1 hereby certify that 1 have completed this work in accordance with MN 7083.0770 and any local requirements.
No determination or guarantee offuture erfomance 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(cr�,gmail.com
revised 312025
Septic Tank Pumping/Maintenance
Owner Information
Date:
�'� Phone:
Owner:t 1 c' . , j-r Email:
Property Address: Owner's Address
(Reason for Pumping:
Method of Access:
(Condition of Tanks:
Filter Cleaned
(Tank Leakage Observed:
Gallons Removed:
#1 //vv1 #2
(Disposal Method:
(Safety Concerns:
(Recommended Repairs:
Comments:
Tank Information
(if different)
❑ Complinace Inspection ❑ Holding Tank (Maintenance
to Manholes 0 Inspection Pipe (holding tanks only)
(Owner's signature req'd if refusing to allow pumping through maintenance hole)
Yes Baffles good: Y,t�s Alarm working: Vs
No No No
/ A N/A N/A
Above operating depth Yes/o (repairs recommended)
Below operting depth Yesyo (failing to protect groundwater)
#3
Municipal:
Land Applied:
#4
tank
Total
0 Location: Watertown Wastewater F
❑ Location:
I hereby certify that I have completed this work in accordance with MN 7083.0770 and any local requirements.
No determination or guarantee of future 7er ce 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@gmail.com
revised 312025