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Report (145) Pe PLM acm -66, SP) ALOHA SANITARY SERVICE INVOICE NO. 8600 SW Hillsboro Hwy., Hillsboro, OR 97123 21 621 503-644-2797 • 503-648-6254 • 503-846-1951 (FAX) www.alohasanitary.com * Email: info@alohasanitary.com NAME: ? C 1 t Yom' �aC ADDRESS: U_; , CITY: ZIP: HOME: WORK: CELL: JOB SITE: .-� �'s - P.O.#: PAID BY CHARGE ❑ CHECK U CASH ❑ CREDIT CARD U ? DRIVER DATE ( ` 76404e°Chet! AMOUNT 'UN PUMP SEPTIC TANK ❑ INSPECTION FEE ❑ SERVICE CALL ❑ LABOR, LOCATING, DIGGING,BACKFILL �® TOTAL $ 1 .R- - Ti#s IS NOTA SEPTIC SYSTEM INSPECTION REPORT- — TYPE OF TANK: STEEL ❑ CONCRETE LI PLASTIC ❑ HOMEMADE ❑ HORIZONTAL ❑ VERTICAL U RECTANGLE , ` U OTHER SIZE OF TANK: 350 ❑ 500 ❑ 750 ❑ 1000. 7 1250 U 1500 Cl 2000 ❑ 3000 U LID LOCATION: INLET CI OUTLET Et MIDDLE ❑ ENTIRE TOP ❑ TANK CONDITION: GOOD ❑ FAIR ❑ POOR FITTINGS: BAFFLES ❑ CONCRETE ❑ CAST IRON;❑ PLASTIC ❑ ?` r GROUND COVER OVER TANK COMMENTS ',77-04/1/0 /ON Customer Signature DATE