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4'4'y .. D /0E--/2/1i_41....,.. I .._ c 7 . -100/ ,70 ALOHA SANITARY ESERVICE ._ INVOICE NO. �� ii. 8600 SW;1iillsbora'Hwy., Hi�tls:�►ci�, OR 97123 , 20521 503-644-2797 * 503-648-6254 • 503-846-1951 (FA ) > ci -, www alahasam ry.com Email: info@alohasanitary.com ( 1 1 r-: • NAME - j CITY: 31)11..9'!'''' ZIP: Ho vv.,. CELL: o"4 --.7.. '44V- Jos 4V-Jos SITE: G5-3 . i1 --6210790 -- PAID BY CHAR o'• CHECK 0 CASH 0 CREDIT CARD ❑ DATE a if . NT CI INSPECTION FEE . all CI SERVICE CALL O LABOR,LOCATING,DIGGING,BACKFILL MI MIMI THIS/S NOTA` SEPTIC SYSTEM INSPECT/4M/QEPORT- - T° "L TYPE OF TANK: STEEL 01 r CONCRETE ❑ PLASTIC O: HOMEMADE ❑ HORIZONTAL CI VERTICAL 0 RECTANGLE 0 0 OTHER SIZE OF TANK: 350 0 500 0. 750 ❑ 1000 O 1250 © 1500 0 2000 ©. 3000 0 LID LOCATION: ` 'INLET0 OUTLET ❑ `MIDDLE CI ENTIRE ToP Cl TANK CONDITION GOOD CI FAIR❑. . POOR O - __FrrrI 1 a : ___. .___.__ .,BAFFLES C: .--CONCRETE U ':