Report D D 4935
�p � PO Box 818,Canby,0R 97013
�i 14 Septic Service Phone:503-682-1929 Fax:503-682-1930
aaffordablesepticservice@gmail.com
www•aaffordablesepticsvc.com
503 682 1929
CCBY158246 DEQ#37918
Customer PO R Contact Phone Date
Name F1;/ 1 n/
'C-S Oiled P/fl Oilp
OQ1i4
Address
67 t`
Technician Mark Payment Check(,Write#) Cash Credit Card Bill Accouct Other
Type:
Descri•tion QTY Unit Unit Price Total
•
Invoice Tota I
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
All Claims MUST be accompanied by this bill