1436 Highview Ave - Septic Maintenance Form 2016-08-24 ---------------------
For Office Use
Date Received:
City of EaEdii
I Staff: I
3830 Pilot Knob Road I
Eagan MN 55122 JUL��I" 7 201
Phone: (651) 675-5675
Fax: (651) 675-5694
Email: commdevelopment(&citvofeaaan.com
SEPTIC SYSTEM MAINTENANCE FORM
Date Pumped: ! )201b #of Tanks Pumped: Total Gallons Pumped:
Site Address: �7 Ph III`
h Yl v �n
Owner's Name: (�" 1 ye� e r —L "9
Owner's Address(if different from site):
S Cam/ I L r S V 1 G�S GfJ ro
Maintainer's Name: 1 .�G ~� License Number: '
Private Residence: Commercial: Disposal Location: '(_
N 15X q .
Condition of Baffles: Type of Tanks: %I/C Size of Tanks: 1J�_
� �
Pumped Through: Effluent Sewage Discharge: Yes: 00 No:
Comments: l o-, t 1.�425 kLE f✓�..vc.o LZ / 1.t,,,
Please submit completed forms to the Building Inspections Division via mail, fax or email.
Satya Bafroop
From: Kirsten Theis[sewerservices.commercial @gmaii.com]
Sent: Wednesday, July 05, 2017 7:15 AM
To: environ @co.dakota.mn.us
Cc: satyab @comcast.net
Subject: Pumping
Satya Balroop
1436 HIghView Ave
Eagan MN 55121
We did an emergency pump out 2000 gal thru manhole 8/24/16
Disposed-Cologne
Thank you and have a great day.
Kirsten Theis
Commercial Account Manager
Sewer Services,Inc.
25648 200th Street
Belle Plaine,MN. 56011
sewerservices.commercial Wgmail.com
952-873-3292
1