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001*1 4 <br />9,9;0 <br />aP 0 <br />�� <br />INVOICE—Septic Service Record <br />Andrew Kleindl L2926 <br />www.'i -excavatio .com <br />95 <br />,1442-7 9 2 8 2 <br />Date of Service: <br />Property Owner �_T, <br />Address: 7cg5 <br />Email Address: <br />Service Record <br />M <br />w-16 Ci d `y <br />oel�ytl,rjl M4v - <br />6�55,5�� <br />Reason: o tinb Pump Service Call Emergency <br />Access Used to Remove Septage: aintenance Hole Other <br />Leaking Observed Yes <br />Disposal Site atertown Treatment FacilitN�> Blue Lake Other <br />Concerns <br />A411 <br />Quantity ,") � cme <br />Description <br />Amount <br />#Gallons #Tanks <br />Pumping/Disposal <br />$=� <br />Repairs—Parts <br />Septic Compliance Inspection <br />Gould Pump Replaced PE41 PE51 <br />Effluent Filter Cleaned <br />Trip~ Labor <br />TOTAL <br />If owner refuses to allow SSTS to be pumped through the maintenance hole, sign this statement, <br />I, refuse to allow the removal of the solids/liquids through the maintenance hole. <br />Owner's Signature: Date: <br />Maintainer Information The work was personally conducted by Andrew Kleindl, of Jim's Excavating. <br />This report will be filed with your appropriate reporting agency. Typically city or county keeps these <br />records on file. All &WN %kindi #2926 <br />