HomeMy WebLinkAboutSWG Pumpers Report / Maintenance - 7/3/2003 e
Mason County Envim m mal MuNtr Dupertmwd
Sepik Tank Pwoping Report Form
Pmp ft OwnerMlaTng Address C A<o) U ` 13, ; ti.,
Site Address
Tax Panel Number ofbmwn Legal Desdiption V Ar f- AS
(➢vmpmc,a rindiny'n) All 1[ims twat Ot Llllecl out completely, ci_el♦ answer as need■d.
Septic Tank lnbrmatlon
1)Tank pumped and inepeclal' ;Dor no
Ef wt fevei: high kjjEjW kw
2)Tank size: )Z-05 gallcns
3)Tank cmngmdlan: u eaa cr horns made
Tank material: metal wood Qotters flbarglass other
4)How mom corrparbr>ants? single cr
5)last Babe oonditjom: rweds repair
Oullot Daft condhion: meads repair
Center Baft corxil I needs repair I not applicable
Eftent tt w deened: yes not ap e
6)Does the system have a pump ohwnloo. (g)/ no I unknown REC�IV E®
Did the pump chamber need b be pu rpeO(FF)i no /not applicable
7)1'adc aandition: damaged 48W> r J�� e 312U05
Were there repairs made to w*or the bir(fles? Yes or& If yes,please explain below. 426 w: CEDAR STa
Orair&W condffbrt: beoklbw irm the tank I seepage In dralrltleld Served profol
B)Location Wwry seppage was disposed e):o _ ►��C .��_
9)abnormal observations:(u rqam*m m&,*=so n)
�e :.. .-..,p C✓l�n��- �,��. t�e+��:a-a-+-e,;C A�✓�-� �s-h�:•.ltss ��`�rl
r►ndlccpa end 4rtvemin,tlone or thi 1nrp�pcl0n rwlleot conUiriana as thkV 4xjot*,l on rice day rho +-PDtir. tank —T,
pumped. No rleim is mad. by hh'.a cAnponyF wit.hnr c prw-awd or implic10s aencacrinV caccess o[ tai..LLre Ot tnt ➢*PM;
Oy4tem-
SVWWre of cerMed purrper Date c� ' 3
Name of Company l'a ire