Correspondence f OM mac,. -3'7 C /C--
ALOHA S ER v I dd L_ -5,
INVOICE NO.
8600 SW Hillsboro Hwy., Hillsboro, OR 97123 n 1 873
503- 644 -2797 * 503- 648 -6254 * 503 - 639 -5188
NAME: k k 0 1 IAh, \\ c Z __
ADDRESS:
CITY: STATE: ZIP:
HOME: (( �1 / WORK: CELL:
.JOB SITE: 1 Lk Co 3 t �1 .1i,, 7( 11(K. f/ 6 AZV / P.O. #:
PAID BY CHARGE ❑ CHECK ❑ CASH ❑ CREDIT CARD
. DATE 0 Z- 0 C - Z j6 DRIVER ()i (JL 74404 2loaf AMOUNT
E PUMP SEPTIC TANK Z7J v ''
❑ LINE OPENING (
❑ INSPECTION FEE I
❑ SERVICE CALL I
❑ LABOR, LOCATING, DIGGING, BACKFILL I
❑ MATERIAL I ` ' '
A. t I
ill t d D n I
- - THIS IS NOT A SEPTIC SYSTEM INSPECTION REPORT-,— .! - IT PAL $ Z7r "Si/
/ /g - - R EMARKS �' ) _I t
TYPE OF TANK: STEEL ❑ CONCRETE ❑ . PL °TIC/® , HOME, D E ❑
HORIZONTAL ❑ VERTICAL ❑ R .CTANGLE U ❑ OTHER
SIZE OF TANK: 350 0 500 ❑ 750 ❑ 1'000 ❑ 1250 ❑ 1500 ❑ 2000 ❑ 3000 ❑
LID LOCATION: I NLE T ❑ OUT T ❑ \- 111DDLE ❑ ENTIRE TOP ❑
TANK CONDITION: GOOD ❑ FAIR ❑ POOR ❑
FITTINGS: BAFFLES ❑ CONCRETE ❑ CAST IRON PLASTIC 1:1
NEEDS NEW LID? YES ❑ SIZE
GROUND COVER OVER TANK N N
COMMENTS ON CONDITION OF DRAINFIELD ETC. \',
\\
SIGNED BY DATE