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tuP , •17- 0a.2eg AL „ A AN1TARY et,a AOH ::- ERVICE 8600 SW Hillsboro Hwy., Hillsboro, OR 97123 21 ,4 503-6442797 * 503-648-6254 • 503446-1951 (FAX) L walohasanitary.com * Email: info@alohasanitary.com -,..E,_N__°_el, ,.4_i_ NAME: ADDRESS: 7 ;*), AC .S.14 1Lark!.. CITY: 1,,Y riile4.14‘," .77_,C , ZIP: Viz'ICI HE +4 WORK: U 1 • t ----L ' .----- ,- °___- ,306 SITE, lelirki/A C I 16,.._ 17,_,L(zulr,I1___14,e4. P,O.#: 1 PAID BY CHAR . 4! CHECK 3 CASH J CR_ES_IILCARD J ., •-', / :1 ;‹, .,, ,s,DATE CA/Z16, ""61 - DRIVER ' 4 _ MOUNT t .Y. Li INSPECTION FEE 1 1-..,,:j Q LJERVICE CALL _ J Lao ,LOCATING,DIGGING.BACKFILL Illi r . / / , — .72VZ c.,,kPi- , L. 1 ; — ----- — j, [TOTAL $ ' - i, ,,,, -,V 4 472- -/- .S'r,rL 7,4 Ar ine Sf-4747", '",, A':, '' : ' - 0/ i / ,,3® / TYPE OF TANK: *. EEL LI CONCRETE J PLASTIC :3 HOMEMADE LI HORIZONTAL J VERTICAL J RECTANGLE D Li OTHER SIZE OF TANK: 350 U 500 j 750 D 1000 3 1250 Li 1500 J 2000 U 3000 3 LID LOCATION: INLET J OUTLET 0 MIDDLE j ENTIRE TOR J TANK CONDITION: GOOD U FAIR LI PooR J I Fill!NOS: BAFFLES :„„) CONCRETE J CAST IRON 3 Pt AsTic 0 , GROUND COVER OVER TANK COMMENTS , --T . _ ,,,,,,,,,,„7- Customer Signatu \tie I ," ,..„,..."'