HomeMy WebLinkAbout1580 6th Avenue North - Septic Pumping Report (59)Septic Tank Pumping/Maintenance
Owner Information
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Phone:
Owner: Let<'7
�er
Email:
i
Property Address: 4`(C> d0
eSfre�:f
Owner's Address
(if different)
Tank Information
Reason for Pumping:
❑ Complinace Inspection
❑ Holding Tank
Q-I'viaintenance
Method of Access:
D<anholes
❑ Inspection Pipe
(holding tanks only)
Condition of Tanks:
(Owner's signature req'd if refusing to allow pumping
through maintenance hole)
Filter Cleaned
Yes Baffles good:
es
Alarm working: Y D
No
No
N/A
N/A
N/A
Tank Leakage Observed: Above operating depth
Below operting depth
Gallons Removed:
#1 l00 U #2 !DO U #3 #4
Disposal Method: Municipal: Q
Land Applied: ❑
Safety Concerns: n 607e-
Recommended Repairs: h on
Comments:
Yes/c)(repairs recommended)
Yes/I�f>� failing to protect groundwater)
tank
Total Z SW
Location: Watertown Wastewater Facil
Location:
I hereby certify that I have completed this work in accordance with MN 7083.0770 and any local requirements.
No determination or guarantee offuture sy1:7
e has been nor can be made.
Chip's Septic Service, LLC & SSTS
r--irtzer's Sewer Services --7License
. _ , 62 Babcock Avenue Maintaner Signature #2064
Lester Prairie, MN. 55354
(952) 200-3176
chipseptic �r��inail cone
revised 312025
Septic Tank Pumping/Maintenance
Owner Information
—,te: 3�Z(o Z5
Phone:
Owner: Cl/V%e 3-
Pe-4ce:w-%
Email:
4Xf/a Ch4eQ 01;/le,—
Property Address:
Owner's Address
if different)
( fferent)CA
s�,re,ls
r61A
.Sha.kC
a /s'I.ji
Tank Information
Reason for Pumping:
O Complinace Inspection O Holding Tank
[i, .-hfaintenance
Method of Access:
[Manholes
O Inspection Pipe
(holding tanks only)
(Owner's signature req'd if refusing to allow pumping through maintenance hole)
Condition of Tanks:
Filter Craned
Yes
Baffles good: es
(;es
Alarm working: Y0
o
No
N/A
N/A
N/A
Tank Leakage Observed: Above operating depth
Below operting depth
Gallons Removed:
# 1 `0,0 () #2 `d Q U #3 #4
Disposal Method: Municipal: 0
Land Applied: 0
Safety Concerns:
Recommended Repairs:
Comments:
Yes/ (repairs recommended)
Yes/1o(failing to protect groundwater)
Location:
Location:
/` zX
tank
Total Z ()
Watertown Wastewater Faci
I hereby certify that 1 have completed this work in accordance with MN 7083.0770 and any local requirements.
No determination or guarantee of fu ante has been nor can be made.
Chip's Septic Service, LLC & SSTS
c- irtzer's Sewer Services License
J.
02 Babcock Avenue Maintaner Signature #2064
Lester Prairie, MN. 55354
(952) 200-3176
chipsepticL&gmail.com
revised 312025
Septic Tank Pumping/Maintenance
Owner Information D 9
Phone: .��_ 7 _ L;-
Owner: Email:
Property Address: ULiC N Owner's Address (if different)
�s3s�
Tank Information
Reason for Pumping: ❑ Complinace Inspection O Holding Tank Q�Maintenance
Method of Access: Q-K' nholes ❑ Inspection Pipe (holding tanks only)
(Owner's signature req'd if refusing to allow pumping through maintenance hole)
Condition of Tanks:
Filter Cleaned Yes Baffles good: 0 es Alarm working: Xss
No No No
N/A N/A
Tank Leakage Observed: Above operating depth Yesh�(repairs recommended)
Below operting depth Yes/
1(�o�(failing to protect groundwater)
Gallons Removed:
# 1 / Z52 #2 2 5-u #3 #4 Pump tank '7-<7-) Total � Z-,>b
Disposal Method: Municipal: Q Location: Watertown Wastewater Facility
Land Applied: ❑ Location:
Safety Concerns:
Recommended Repairs: lv?,P"-j -/-) -,t;jex —
Comments: r� 1J Jf-L. , -I / -L I. -
I hereby certify that I have completed this work in accordance with MN 7083.0770 and any local requirements.
No determination or guarantee offuture75tan:nature
hasor can be made.
Chip's Septic Service, LLC & SSTS
Sf--�rtzer's Sewer Services License
i .,2 Babcock Avenue anerSig#2064
Lester Prairie, MN. 55354
(952) 200-3176
chipsepticgmail.com
revised 312025
Septic .Tank Pumping/Alaintenance
Owner Information
Phone:
Owner: i_�k!
Email:
Address:
��... Owner's Address
Reason for Pumping:
of Access:
of Tanks:
Filter Cleaned
Tank Information
❑ Complinace Inspection ❑ Holding Tank
V.-dw � W �
(if different)
Maintenance
Manholes ❑ Inspection Pipe p (holding tanks only)
(Owner's signature req'd if refusing to allow pumping through maintenance hole)
Yes Baffles good: >/es Alarm working: e0s
No NoY"'N/A
N/A
Tank Leakage Observed: Above operating depth
Gallons Removed; Below opening depth
# 1 -> #2 #3 #4
Disposal Method: Municipal:
Land Applied: ❑
Safety Concerns:
mended Repairs:
ents:
Ye (repairs recommended)
Y o(failing to protect groundwater)
Pump tank 7 Q Total 0`�',7n—c)
Location: Watertown Wastewater
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 syste a omance has been nor can be made.
Chip's Septic Service, LLC &
S—rtzer's Sewer Services SSTS
I - ..,2 Babcock Avenue License
M
Lester Prairie, MN. 55354 aintaner Signature #2064
(952) 200-3176
chi se �ticicinaii.com
revised 312025