995 Cliff Rd - Septic Maintenance Form 2017-07-12 5325 MANNING AVE. SO.,AFTON, MIN 55001
eye Family Owned Business Since 1976
fewer LANA MEYER
SerVice (651) 459-0162
Liquid Waste Pumped•Portable Toilet and Sink Rental
www.MeyerSewer.com
CHECK CASH CfL4R.UE CREDIT CAftD CNARC3E5 DATE
PLEA5E CALL _.
NAME
38 7
PUMPED AND BACKFILUS
111()Vr'-(ffow Tank
Cesspoof'---
Holding Tank
Lift Station II
Distribution or Junction Box
Extra BackflUshing
feet of hose(Extra charge for over 100 feet of hose)
Aishington County Fee II
PUMPED:
Sandtrap
Sump
Other:
Weekend or Evening Charge
RECEIVED BY i.
X TOTAL
TOTAL GALLONS:
Pumped through manhole or inspection pipe
0--)
Septic tank: Pre,,cast -',Block-Plastic-Unknown Rf k
, 1-1 r)
Overflow tank 1,,Freadst-Block-Plastic-Unknown A-
Condition of baffle: Cxpoq, Repair Needed,or Unknown
Drainfleld:
,Meutlnd,Ttenich,or Unknown
Effluent gurL Ncr,
kqq_Acharge: Yes-or-
Lift Station: Yes or No BBB
T—
Comments:
Llo.nsed,Bonded•Insured
Licensed by the
Mw.sota.Pollution Control Agency