Report (106) e��•A PLM.101'1--c olo
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PO Box 818,Canby,OR 97013 •
• Septic Service Phone:503-682-1929 Fax:503-682-1930
-h�i:e.e..o..-..tee-eeff,.. G�� aaffordablesepticservice@gmail.com
www.aaffordablesepticsvc.com
503-682-1929 CCB#158246 DEQ#37918
Customer PO# Contact Phone Date
-CO 1 ' '26 a- 8 i?/ 83,0 -)
Name
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Address r, f 1
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4 4 // g,/Z. , ? O
TechniiciaanJ(
/-.14.44,
Mark Payment Cfiyteck�(Write#) Cash Credit Card Bill Account Other
Type: /T qs
C Dcscr P
ption . QTY Unit Unit Total
i ,../,........10...dy._. )
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Invoice Total €11/0'e." ---
Recommendations
e. —
Recommendations(if any):
It is the purchaser's obligation to clearly mark underground utilities and underground irrigation systems.
A-Affordable Septic Service is NOT responsible for unmarked utilities and/or irrigations systems.
Signature
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All Claims MUST be accompanied by this bill
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