HomeMy WebLinkAbout920 Wayzata Boulevard West - Septic Pumping Report - 2025Septic Tank Pump ing/Maintenance
Owner Information
Date: %aZ. ` d� Phone: 7 . , - -;MY - (kq 1n1.
Owner: 4Y„ vuu 04-,L jL -Qej Email:
Property Address: Owner's Address (if different)
�b� l rt A4
Tank Information
Reason for Pumping: ❑ Complinace Inspection ❑ Holding Tank Maintenance
Method of Access: Manholes ❑ Inspection Pipe (holding tanks only)
(Owner's signature req'd if refusing to allow pumping through maintenance hole)
Condition of Tanks:
Filter Cleaned Y/s Baffles good: )I's Alarm working: 4s
No No No
N/A N/A N/A
Tank Leakage Observed: Above operating depth Yes (repairs recommended)
Below operting depth Yes/I�o (failing to protect groundwater)
Gallons Removed: ////
# 1 .
tJ #2 /�� #3 #4 Pump tank Total �04>
Disposal Method: Municipal: Q Location: Watertown Wastewater Facility
Land Applied: ❑ Location:
(Safety Concerns:
Recommended Repairs:
(Comments:
I hereby certify that I have completed this work in accordance with MN 7083.0770 and any local requirements.
No determination or guarantee offuture system perfomance has been nor can be made.
Chip's Septic Service, LLC & SSTS
Swartzer's Sewer Services License
16762 Babcock Avenue aintaner Signature #2064
Lester Prairie, MN. 55354
(952) 200-3176
chipseptic@jzmail.com
revised 312025
Septic Tank Pumping/Maintenance
Owner Information
Date: (9, 12 - al�; Phone: - -
Owner: j V- Mass a ��1G¢Y Email:
Property Address: Owner's Address (if different)
O7r •wr't,
Tank Information
Reason for Pumping: ❑ Complinace Inspection ❑ Holding Tank Maintenance
Method of Access: Manholes ❑ Inspection Pipe (holding tanks only)
(Owner's signature req'd if refusing to allow pumping through maintenance hole)
Condition of Tanks: o
Filter Cleaned Yes Baffles good: es Alarm working: �s
No No No
- N/A N/A
Tank Leakage Observed: Above operating depth Yes o (repairs recommended)
Below operting depth Yes (failing to protect groundwater)
Gallons Removed:
# I 16jo #2 AA#3 #4 Pump tank Total X�
Disposal Method: Municipal: Q Location: Watertown Wastewater. Facility
Land Applied: ❑ Location: —
Safety Concerns:
Recommended Repairs:
Comments:
1 hereby certify that I have completed this work in accordance with MN 7083.0770 and any local requirements.
No determination or guarantee offuture system per omance has been nor can be made.
SSTS
Lice
Chip's Septic Service, LLC &
Swartzer's Sewer Services License
Maintaner Signature #2064
16762 .Babcock Avenue
Lester Prairie, MN. 55354
(952) 200-3176
chipseptic agmail.com
revised 312025
Septic 'rank Pumping/Maintenance
Owner Information
Date: IQ— // - .23— Phone:
Owner: 4_C5r1 t"1 i G �r�d�. _ Email:
Property Address.- �+ ( Owner's Address (if different)
Lq
UrCrl1 �. /nail 6 J Su l 2 _
Tank Information
Reason for Pumping: ❑ Complinace Inspection ❑ Holding Tank Maintenance
Method of Access: 'manholes ❑ 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: Alarm workings
No No 0
N/A N/A
Tank Leakage Observed: Above operating depth Yesy (repairs recommended)
Below operting depth YesIlWo (failing to protect groundwater)
Gallons Removed:
#2 #3 #4 Pump tank 06x.) Total'�%�
Disposal Method: Municipal: Q Location: Watertown Wastewater Facility
Land Applied: ❑ Location:
Safety Concerns:
(Recommended Repairs: r,�t__ mist. risn S -h —k-s
(Comments:
1 hereby certify that I have completed this work in accordance with MN 7083.0770 and any local requirements.
No determination or guarantee offuture system mance 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@amail.com
revised 312025