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HomeMy WebLinkAboutMiscellaneous - 175 GREAT POND ROAD 4/30/2018I O � VG7 .Z1 0 m p Di O � g v o D 0 0 A� a Reg N/C alum ofService ASP)rReg. Ma! int. 0 0 Emergency ANDOVER SEPTIC PUMP RS Day C3 Night PAY FROM THIS BILL Customer Name: P.O. Box 4173 B Station Andover, MA 01810 (508) 475-2593 Professional Septic & Drain Service Location, 4i Phone: Contact: Locally Owned and Operated'' Emergency 24 Hr. Svc. — 7 Days Billing Address: City: Zip: Special Instructions Completed Completed Per: Per: Reason: AM/PM Services Rendered Vac um Pumping Septic Tank C1 Drywell , 11 Leech Pit /:Overflow 0 D -Box oe 0 Pump chamber 0 Grease Trap P� E3 Catch Basin. 11 Portable Toilet 11 Other Qty: Size: ❑ Under 1000 gallons 0 1000 gallons 0 1500 gallons !000 gallons 0 3060 gallons 0 4000 gallons Observations Good Condition 0 Leechfield Runback/t/0 0 Riding High MO (liquid level) n 0 Full to Cover El ExcessivelidWO Top / Bottom 0 Use No Powdered Soap 0 Heavy Grease 0 Roots 0 Suggest Electric Rootering 0 Van Called Drain Cleaning 0 Main Line C3 Toilet Bowl C3 Ktchen Sink El Bathtub / Shower 0 Vanity 0 Floor Drain 0 Yard Drain El Vent 11 Sewer Jet C3 Other Footage: 000 gallons 0 other 0 Other Misc. 0 Digging Charge 0 Backhoe El Location Win. 0 Consultation 0 Inspection firs. 11 Certification: P/F C1 Service Call C3 Est;mato Reason: 0 Labor 0 Portable Toilet Rental 0 Pump Repair C3 Waiting Time 0 Baffle 0 Repair Digging Charge Is Per Driver C3 Chemical Treatment Discretion C1 Other Description of Work ir,/ ce, Recommendations Terms of Payment Vacuum Pumping Drain Cleaning Yr. Month Month n th NET 1 5 DJASY S Parts Tax Discount :Te;7tT* Conditions ❑ Cash 0 CheckP'Cri 1. :Not es ponsible for damage beyond curb line. (2, ornpiaints�shwl be repbried4ithin 48 hours. dit 3. 1. 3. 1.50 per month will be charged to accounts past due. ` 4. —,T 9 purchaser agrees to pay all cost of.collection. 6 TO / � .<, :Qj t e"undersigned agi Customer Signatu4,,; uyt,e all T1111ut" 1UL;Vr1L;1L19i`1:J. Servicema ,2L SEPTIC SYSTEM INSPECTION FORM ADDRESS nATF. TNRPFrTFn d r' PROPERLY FUNCTIONING? (0 N WEATHER CONDITIONS COMMENTS: - WATER QUALITY TESTED? RESULTS? ;DYE TEST PERFORMED? Y N DATE? SKETCH: