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& B SEPTIC SERVICE, INC. <br /> 7525 WINDSOR ISLAND RD, NORTH SALEM, OREGON 97303 <br /> (503) ~9~-1311 <br /> <br />D.E.~ LiCit!SE NO,33008P-1 B.P,. N0.858!~ <br /> <br />PROPERTY OWNER: ~7/~4 <br />ADDRESS OF TANK PUMPED: .... '~ ii ~/~ ~ 5 ,/~'7~ ~ ~--~ <br /> ,¢~ ~ 5 ~'//¢ ?23 2 <br /> <br />APPROXIMATE SIZE OF TANK: ~ 6ALL02S U v <br />TANK CONDITION? 600D~/> FAIR.~ CONCRETE~/~ OTHER. <br />ARE BAFFLES OR ELB09S IN PLA~E? YES~/PNO .. <br />EFFLUENT PU~P ~0 PU~P TANK ~) DOSIN6 SYSTE~ <br />DRAiNFtELD WORKING~¢/~ SURFACING ~, , SLUGGISH <br />SOLIDS: NORMAL EXCESSIVE~m <br />REPAIR NEEDS: INLET~ OUTLET~4MAINLINE~_ LID ~ <br />HOUSE VACANT,~ OCCUPIED~ <br />~UMBER OF PEOPLE IN HOME: PRESENT ~ PREVIOUS~ <br />NUMBER OF YEARS SINCE LAST PUMPING <br />RECOMMENDED PUMPING INTERVAL: <br /> <br />SIGNAfURE <br /> <br />OF PUMPER: <br /> <br /> <br />