HomeMy WebLinkAboutCOM2005-00105 - SWG Pumpers Report / Maintenance - 9/27/2000 rzt:':,-.,• .'' - Veg. 1 ,,,' 41- 11 .T3. ' .- ,,..o.c
. •. County Environmental Health Department 'e
Septic Tank Pumping Report Form r 4'
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(ct ,:errs rira,.,g's) All items ^ust be filled out completely, circle answer as needed. w1 %hj
Septic Tank Information t-il lre :-
ECEIVED >< N
SEP n , >���fi��, �,
n , a_:k.. pl.J ed ...:d _r.5' ffes Or no 2 2 2005 .`�* t r a.:
F:_ ent leve l. . � .;g nor ; / low :r�T 8E ✓i �, � '
LFAIR OFFICE `gi *;;a +�,j''
f Sy� t r JG';
'".=•x-:. f Jnstrr-ct:ri:_: �-�atacturera)or home made �l �+eS:,/�,�4,.�
'?'s.�.: mat6r .al. metal wood corret-eE fiberglass other i ,;t. . •.* ej; ,r
: �' .ally compartments? sine e O �O'G7� r '''� fit'A�. 1` `�.
2affie cond:.'.icn: «tisfactor / needs repair . i -:i1; ' .
.,i 3c fie cor.tditio:�: Lam__. .,i c4o.. r / needs repair 4+ ` �' A'i
.e condition: -,. _s_acroi r ec.s repair / not applicable ' 0.. g
_,.... -cer cleaned: yes / no / cot app:icab13) `t i .v
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,.•r .Jt:'-'.s system have a pump chamber? yes / r:J / unkno t ,t "'.,� 4s2 F,`' ;,
D 7._� ...:,:o ch;,..::�ter need to be pumped? es / no + 1 �+
��- .e- p: p ? y / of applicable / }f/F` :, to
.7) Tank condition: damaged /( ) �.J.x �r Y, f , a.
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=i- the tank or tY_e baffles repaired? 'yes re / not applicable ,i.:�- 1 ` f;4 ''>:`,
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1 Solis level (optional) : Sludge / Scum t
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!Dra:.:s ieid condition: backflo�•i into the tankl~il s "h / seepage in drainfield :ae
�o observed proole s ;rev'° :!r ^1".1;;
• ^P: oc 4ticn ,+:e_c .eptace as disposed •
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,4 , ..tr,b:::,%5. . �':;�:e':`✓c:tic:3: (:f repairs were msde, please explain) �►�� �� k
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Findings and deters..:nations u•i this inspecticr• reflect conditions as they existed on the day the septic tank r` rU` , r } {.,
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a.. pt=ped. ko c!a::r, is ,:ad.: y ,his coTpany, either expressed or implied, concerning success or failure of the' ,:/rr�jcty l , �i.
Apti'c systc':. f';k '
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3 :a._U- - O� certified oer / J�,2- -� / Date 2 1 ��., i` 4`r
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