1250 Deerwood Dr - Septic Maintenance Form 2015-08-26 x
DAKOTA COUNTY SEWAGE SYSTEM MAINTENANCE LOG
D pumped:_,�,_ff, No. of Tanks Pumped:�_ Total Gallons Putap�:��--
Owrt Site Address: r A
Nluniaipati#yFrownship: Owner Address:
Vdvate Residence ❑ Rental ❑Commerial (Owner desefibed type of tank(s) ❑Yes a NO)
Septage Disposal Location: locap Condition of Baffles:
Type of Tank(s) 1 2 3
(septic to , holding tank, cesspool, pump tank,sand trap,flammable water trap, etc.)
Size of Tanks) 1 3
Pumped through: G(M'an-hole 0 InspeCUOn Pipe Effluent Surface Discharge: [] Yes T�No
Comments:
LwW�� M Akdm WMIU Loss AQW
,w added ph W"� ph alax3Q - - GM-Applod TotW-Q a:/X4W t*Atw YTQ
pn MAP 302016
Sir Z3
Mike's Septic Service
16961 Mushtown Road Sales Receipt
Prior Lake,MN 55372 Date Sale No,
952 440-1800
8126!2015 11583
Sold To
Hansen,Icon
1254 Dbrwood Dr
F..�atiy JldJ1i S,SJ23
Check No. Payment Method Project
10463 Check
Description Qty Rate
Amount
Pumping Septic System 1 Tank Manhole
Metropolitan Waste 1 200.00 200.00
�P�Charge 1 75.40 75.00
Permit sent to Dakota County
PAID IN FULL
Thank you for your businessl Cody McKinley
Total $275.00