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3505 Trails End Rd - Septic Maintenance Form 2022-06-16EAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 Plan Submittal: eplans a)cityofeagan.com --------------------- For Office Use I I Date Received: I I I I I Staff: I I I SEPTIC SYSTEM MAINTENANCE FORM Date Pumped: (,,.,- j (0 • # of Tanks Pumped: Site Address: �,� ` r �`S �� 1C0�C' Owner's Name: C Owner's Address (if different from site): Owner's Email: \C-_> VAre r Total Gallons Pumped: l �� Owner's Phone #: (91 �--1 "- q _l-7 ~ 94 17 Maintainer's Name: �X S C� ,YCa�Y1'� License Number: v� Private Residence:_ Commercial Condition of Baffles: Pumped Through: Comments: Disposal Location: E'M () i r Type of Tanks: �)Q� t-- Size of Tanks: loco LI ��c�Yl \( +Y 59C -c I3 Effluent Sewage Discharge: Yes: No: (` cky u w -e k -sgo-\�, -k-cVX aA W " 'F_�cury-\ G_\ -\A cS S6�4L Name of Person Completing Form: V��� ux� Date: LP — kLo You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. Please submit completed forms to the Building Inspections Division via mail, fax or email. 7/8/22,1:24 PM Edit Pump Log Address: 3505 TRAILS END RD, EAGAN, MN 55123 Name: SCOTT D & CYDNEY A WELTER Last Pump: 6/16/2022 Gallons: 1000.00 Business LaRoches Inc Pump Date 06/16/2022 G Gallons Pumped i 1000.00 l_ Watertight Tank FYes i Waste Backup No Abandoned No� Comments The tank had a great deal of sludge present. Edit Pump Log https://services.co.dakota.mn.us/onlinesepticportal/PumpLogs/Editt33894 1/2