HomeMy WebLinkAbout4625 West Branch Road - Septic Pumping Report - 2025Septic Tank Pumping/Maintenance
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Owner Information
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Owner:-,�,,� _ Email:
Property Address: Owner's Address (if different)
Tank Information
Reason for Pumping: ❑ Complinace Inspection O Holding Tank Maintenance
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 Cleaned Yes Baffles good: s Alarm working: Yes
No zoo*
No
N/A ��' A
'tank Leakage nhserN ed: Above operating depth Ye (repairs recommended) �
Below operting depth Yes o (failing to protect groundwater)
(...,ions Removed:
�91 1 r" :.) #2 =,W #3 #4 Pump tank Total 6W
Disposal Method: Municipal: Q Location: Watertown Wastewater Facil
Land Applied: ❑ Location:
Safety Concerns:
mended Repairs:
(Comments: `AN.—( -11-�.AA 11 rll. ,
1 hereby certify that I have completed this work in accordance with MN 7083.0770 and any local requirements.
No determination or guarantee of future syste ante has been nor can be made.
Chip's Septic Service, LLC & SSTS
_S"rtzer's Sewer Services License
j2 Babcock Avenue Maintaner Signature #2064
Lester Prairie, MN. 55354
(952) 200-3176
chipseptic&Lnail.com
revised 312025