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Pumping Report <br />Lic:2502Sewer Services lnc. <br />Date Serviced: <br />Scheduled Maintenance:Emergency Services: <br />Driver: <br />Start time: <br />Type: Residential Commercial <br />Stop time <br />Address <br />Did you measure the accumulation of scum and sludge?Yes No, pumped regardless <br />Phone <br />City: <br />Tank 1 Tank 2 Tank 3 Tank 4 Pretreatment Pump Tank <br />Gallons Billed <br />Scum <br />Sludge <br />% full <br />Operating Depth <br />Access used <br />Depth to lid <br />|,refusetoallowtheremovalofthesolidsandliquidsthrough <br />the maintenance hole. I understand that removal of solids and liquids through other access <br />points is not considered a compliant method of solids removal and does not fulfill the solids <br />removal requirements of Minn, R. 7080.2450 and 7082.0600 <br />Owner's Signature: <br />Tank Type - Precast - Block - Concrete - Plastic - Other <br />Filter: Yes No Type of system: tr/ound - Gravity - Holding Tank - Elevated Trench/Bed <br />Type of waste: Domestic - Holding <br />Are tanks leaking above or below flow line? Yes No lf yes, where: <br />Did you observe sewage discharging onto the ground surface? No Yes, <br />Pump Size: Electrical condition: <br />Are all of the covers securely replaced? Yes No, <br />Safety concerns: <br />Disposal site: <br />Next recommended pumping:Length of hose required <br />Co m ments/Trou bleshooti ng/Repai rs: <br />Location of tanks in yard <br />Sewer Services lnc. 25548 200th Street - Belle Plaine, MN 55011 '952-873-3292 <br />Septic tunks should be pamped every I to 3 years. <br />Muny diffirent vurisbles determine how often <br />u tunk needs pamping: <br />Billins Information <br />Pumping (first 1000 gal.) <br />Additional gallons : <br />Name: