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Report Sep 21 09 07:47a HOLLENBACH AND HURD IN 503 - 848 -6832 p.2 pal , C)C) - oo /63 P. ALOHA SANITARY S ERVICE INVOICE NO. 8600 SW Hillsboro Hwy., Hillsboro, OR 97123 1 4 5 3 4 503 -644 -2797 • 503- 648 -6254 NAME: /(�' �'��C /i� ,' = "re ' �- _. X11" ADDRESS: CITY: STATE: ZIP: HOME: WORK: CELL: -r 7bi 3 q JOB SITE: (Ye/ iS1 1 Y /44" 4, 77,,; +', .o. #: PAID BY CHARGE, CHECK ❑ CASH ❑ CREDJT CARD ❑ DATE /C - DRIVER l ,/ :/. &" 7Oam.4licat AMOUNT PUMP SEPTIC TANK \174 de2 ❑ INSPECTION FEE ❑ SERVICE CALL ❑ LABOR, LOCATING, DIGGING, BACKFILL 7. l/' 4' r7�d 4 1 - THIS Is NOT A SEPTIC SYSTEM INSPECTION REPORT - - TOTAL -- REMARKS TYPE OF TANK: STEEL ❑ CONCRETE ❑ PLASTIC ❑ HOMEMADE ❑ HORIZONTAL ❑ VERTICAL ❑ RECTANGLE ❑ ❑ OTHER SIZE OF TANK: 350 ❑ 500 ❑ 750 ❑ 1000 ❑ 1250 ❑ 1500 ❑ 2000 ❑ 3000 ❑ LID LOCATION: INLET ❑ OUTLET ❑ MIDDLE ❑ ENTIRE TOP ❑ TANK CONDITION: GOOD ❑ FAIR ❑ POOR ❑ FITTINGS: BAFFLES LI CONCRETE ❑ CAST IRON ❑ PLASTIC ❑ NEEDS NEW LID? YES ❑ SIZE GROUND COVER OVER TANK COMMENTS ON CONDITION OF DRAINFIELD ETC. SIGNED BY DATE „ 9" -�' •• ��� • Sep 21 09 07:47a HOLLENBACH AND HURD IN 503 - 848 -6832 p.3 i. ` 36 en c & 3-furci inc. .____ 3430 -A S.W. 209th Ave., EXCAVATING AND UTILITIES Office (503) 591 -5987 Aloha , OR. 97007 -1073 OCCB #121807 Fax (503) 848 -6832 Email: handh20@Juno.com RESIDENTIAL SANITARY SEWER AS -BUILT Date: 9.- 05 • Permit # _.& / e.ef ePOO4' - ey_3/ Building Contractor: e:24. -- U' - rAnt ,,4•74.i Subdivision: Address: 9/b .S" ,o ex/ >wil, (dtu,�/.4 i e 74f/ Depth of Connection to City Stubout: ', ' Distance off curb to City Stubout: 9/ Type of Pipe: a g 5 %I" - A O 4" c 3 Size of Pipe: ge-,1" Type of Connection: 4/" f= rrz7 > Inspection Date: 9 !S` =C) . ii I or, a' 0 - 1 r . . - -A dii, . i ' e 1 1 I • I V 4 r [— -' 9 . i 1A eQ �i `' j oak ' A kt,, o IOC) 1 .pre' —. �'1 r 4 K..1( it`d1 ,( cr -