HomeMy WebLinkAbout4490 Watertown Road - Septic Pumping ReportSeptic Tank Pumping/Maintenance
Owner Information
Date: f/./-Z Phone: Z— 0 eT Z 7 0
Owner: �j' fT e C=�/��g Email:
�r0p��t flddress; I U )italllLwn ij Owner's Address (if different)
Tank Information
Reason for Pumping: ❑ Compl i nace i nspecti on ❑ Holding Tank ( t�Pofaaintenance
Method of Access: anho Ins Q'1� es i ❑ Inspection p Pipe (holding tanks only)
(Owmer's signature rey d if refusing to allow pumping through maintenance hole)
Condition of Tanks:
Filter Cleaned
(Tank Leakage Observed:
Gallons Removed:
##1 /f)nh #2 166 A #3
Yes Bafflcs good;
No
NJ
Above operating depth
Below operting depth
(Disposal Method: Municipal:
Land Applied:
'Safety Concerns:
lRecommended Repairs:
(Comments:
#4
cs Alarm working: (n!)
No No
N/A N/A
YC (repairs recommended)
YeC> (failing to protect groundwater)
tank
Total
Q Location: Watertown Wastewater Facili
❑ Location:
R"M
L
0tk.J' -- ILTn Eta-.,W -I- )', kJ 4/1 use-h -- ( 4-, 1
1 hereky certij� that I have completed this work itt accordance with MN 7083.0770 and aiiy local requirements.
No determination or guarantee of future syst anu 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
chijseptic ,gtnail.com
r"iald 312025