945 Butwin Rd - Septic Maintenance Form 2021-07-200. 0
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EAGAN
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3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694
Plan Submittal: eeplansCcDcitvofeagan.com
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For Office Use
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Date Received: I
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Staff:
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SEPTIC SYSTEM MAINTENANCE FORM
Date Pumped: 7/20/21 # of Tanks Pumped: 1
Site Address: 945 Butwi n Road
Owners Name: Jewish Community Center of St. Paul
Owner's Address (if different from site):
Owner's Email:
Maintainer's Name:
Private Residence:
Condition of Baffles:
Pumped Through:
Comments:
1375 St. Paul Avenue
Total Gallons 1500
Pumped:
Owners Phone #: 763-300-3667
Pinkys Sewer Service License Number: 1673
Commercial
Good
Manhole
✓
Disposal Location: Met. Council Metro Plant
Type of Tanks: precast Size of Tanks: 1 500
Effluent Sewage Discharge: Yes: No: ✓
Name of Person Completing Form: Plnkys Sewer Service
Date: 3/4/22
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Please submit completed forms to the Building Inspections Division via mail, fax or email.