4732 Dodd Rd - Septic Maintenance Form 2022-06-103830 PILOT KNOB ROAD :I .EAGAN; .MN 55122-181.0
(651) 676-66)161 FAX:. {651 }. 675-5694
Plan Submittal; a tans ci ofea an.coffn
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For Office l
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€ Date Received: 1
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I 'Staff: i
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SEPTIC SYSTEM MAINTENANCE.. FORM
Date Pumped: 6 - 16. - a� # of Tanks Pumped`
Site Address: T I3.1 bo 144 Rockc.
Owner's -Name- ` c) Y Y -0L \ V -\e_ 1 nv-,,
Owner's Address ..(if .different from site):
Owner's Email:
Total. Gallons
Pumped: / 6 Q C7
Owner's Phone #: :(o5 t — (4S `t:' ^ 32) +o
Maintainer's Narne 1t �2.r�V lC.� License Number:
Private Residence'. X_ Commercial: Disposal Location:'
Condition of Baffles Type of Tanks: -VI G. size of Tanks:
Pumped. Through: 6LArna Effluent Sewage. Discharge: Yes: No: v i
Comments.
Name of Person.Completing Form: �. Date.: (0"
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Please submit completed forms to the.Building Inspections Division via mail, fax or email.
6127122,:4:42 PM
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Pump Log Information
Kathy LaRoche <SepticSystems@co.dakota.mn.us>
To:. kath y @ la ro ch e s : com.
Pump Lag information:
Business:
LaRoches Inc
Pump Date:
6/10/2022
Gallons:
1 OOo:00
Septic.
24948
System ID:
.Parcel ID:
100360027040
Address:
4732 DODD RD, EAGAN, MN 55123.
Abandoned:
No
Watertight Yes
Tank:
Wast -Backup: No
Gmail - Pump Log Information
Kathy LaRoche <klaroche1021 @gmail:com>
Thu, Jun -23, 2022 at 12:31 PM
Comments: Serviced the: tank through the. ❑utlet.manway which we exposed - five inch depth. Noted clay baffles are
intact. 10. of sludge recorded.
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