Report (47) E.uP r 17-GD W
�
. �.. r, _ 1 U. Si);., I1?� ?ccl�
.. , INVOICE NO
8600 SW Hillsboro Hwy., Hillsboro, OR 97123
503-644-2797 • 503-646-6254 • 503-846-1951 (FAX)
wwvv.alohasanitary.com Email: info@alohasanitary.com
NAME: K.6,--. ic..0 i.;
ADDRESS: IArJ . J?fit Z...L71 6i.,,,..A.1 — ,
CITY: 45K -ttCl4k>
ZIP: 7&(i 7 HOME: WORK: CELL:'9376'0414V
JOB SITE: f( G� — 3•Z C' /13 7 776.4/2(1 P.O.#: (J1 Ay
PAID BY CHAR. z,Iii I. CHECK U CASH ❑ CREDIT CARD ❑
DATE �? a/''j�707k DRIVERL)J/ i r AMOUNT
PUMP SEPTIC TANK --ti-, t 1r"
-543
❑ INSPECTION FEE
U SERVICE CALL
U LABOR,LOCATING,DIGGING, BACKFILL
A'‘. -7:41,4 _ ,
/ , 1.)--711 KT
. �,� . : i= .'_. �s , TOTAL $ �/
/1/4,1
TYPE OF TANK:
EL U CONCRETE ❑ L
P ASTIC U HOMEMADE ❑
HORIZONTAL ❑ VERTICAL U RECTANGLE ❑ U OTHER
SIZE OF TANK: 350 ❑ 500 ❑ 750 ❑ 1000 ❑ 1250 ❑ 1500 U 2000 U 3000 U
LID LOCATION: INLET U OUTLET U MIDDLE U ENTIRE TOP
TANK CONDITION: GOOD U FAIR U POOR ❑
FITTINGS: BAFFLES ❑ CONCRETE ❑ CAST IRON U PLASTIC
GROUND COVER OVER TANK
COMMENTS
tv ."" . goy
j
r�
fi
Customer Slgnatur
--
DATE/ / �/
t� ✓
N.