HomeMy WebLinkAboutSeptic Design �r1 11Ende Septic Service, LLC
\fp-i 24910 Territorial Road • Rogers, MN 55374
Ill � Phone: 763-428-4489 • e-mail: info(irb,,endeseptic.com
-- ._ MPCA License #: L2654
Date: , — )- y —/ `P Invoice
Reason for Pumping: (, e�,'�,�;,, y Pumping fee: 3 S 0
Long pull fee:
Name:Z hifdeV 4lit4 e 5 Other:
Address: )U C () FC)
k tS-I. Total Cost of Service: 3 50
City/State/Zip:0 Payment Method:
/OA& iciv ./J• ❑ Check ❑ Cash ❑ Credit
r
Septic Tanks & System Condition
Access: L'Maintenance Hole # of Tanks: j Type off;System:
❑ Other Volume pumped: ow m, .nd
Risers: (1:l Yes ❑ No Ma poles to surface: S stem Watertight:
IA Yes O No Yes D No
Baffles KYes ❑ No Effluent scr en: Noticeable s facing:
❑ Yes I No ❑ Yes No
Tank Acce & Structurally Safe: Tank type: Precast Ponding:
611 Yes ❑ No ❑ Cesspool O Yes iNo
Tanks water tight: : jYes ❑ No Pi ng checked: Signs of no -domestic waste:
Yes Nl No ❑ Yes ® No
Length of Pull: \ r Pu/np or Wiring Faul : M� holes Securely replaced:
Yes ❑ Nc4J , ww L Yes ❑ No
Comments regarding system: )(kb) 5 y J tot
?Lii--,c )Sit, '-) Lv4we. tled 1-0 o e✓ re,-f _
I •e -: _ imen•e• at is ii . . Yies U No
OFFICE USE ONLY
Disposal: E Land Application ❑ Wastewater Treatment Plant
Disposal Site: Gallons: Plowed: : ❑ Yes 0 No
Time: Temperature: pH:
Time: Temperature: pH: