865 Lakewood Hills Rd N - Septic Maintenance Form 2023-09-13PO BOX 40
Neyer^o AFTON, MN 55001
Sewer b Family Owned Business Since 1976
SerVice� (651) 459-0162
www.MeyerSewer.com
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CASH
CHARGE
CREDIT CARD CHARGES
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NAME
ADDRESS
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PUMPED AND BACKFLUSHED: U
Septic Tank
Overflow Tank
Pump (Lift) Tank
Holding Tank
Sump
Cleaned Filter
Used Crust Buster to break up thick crust
Extra Backflushing
feet of hose (Extra charge for over 120 feet of hose)
County Fee or City Fee
Disposal Fee
OTHER REPAIRS:
Weekend or Evening Charge
TOTAL GALLONS: ! �� TOTAL
COMMENTS:
BBB
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Licensed• Bonded -M"' -d
RECEIVED BY: Licensed by the
1.2115 7l " Rei No: G158805908