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HomeMy WebLinkAboutMiscellaneous - 60 WOODCREST DRIVE 4/30/2018El, Reg Nature of Service ASP ❑ Reg. Maint. ❑ N/C �/Emergency ANDOVER SEPTIC PUMPERS ❑ Day ❑ Night Date of Service � � � --� �,,. -- � , --13 (`" � PAY�FROM THIS BILL Customer Name: P.O. Box 4173 B Station Andover, MA 01810 (508) 475-2593 �,%/ % �✓ Service Location: ,�j , / ��"�" Phone: ,.' �l�'i • ( - � (508) 664-0640 Professional Septic & Drain Contact: / Locally Owned and Operated Billing Address: f%�, Emergency 24 Hr. SVC. — 7 Days City: ,,--' zip: Special Instructions © Com leted ❑ Incomplete Reason: Per: AM/PM Services Rendered Vacuum Pumping Observations Drain Cleaning ❑46ptic Tank ❑ Good Condition ❑ Main Line ❑ Drywell ❑ Leechfield Runback ❑ Toilet Bowl ❑ Leech Pit / Overflow ❑ Riding High ❑ Kitchen Sink ❑ D -Box (liquid level) ❑ Bathtub / Shower �.7 Pump Chamber ❑ Full to -Go er /'Excessive Solids ❑ Vanity ❑ Floor Drain �) Grease Trap ❑ Catch Basin % Top/ Bottom 'DEl Soap Yard'l�se-Use [-1PortableToilet El Other El Heavy Grease El Vent El Sewer Jet Qty: ❑Roots ❑ Other Size: ❑ Suggest Electric Footage: ❑ Under 1000 gallons ❑ ❑ 1000 gallons ❑ 1500 gallons ❑ Rootering ❑ Van Called ❑ 2000 gallons 3000 gallons 4000 gallons ❑Other El5000 gallons ❑ other Misc. n 11 Digging Charge i ft1in. hrs. ❑Backhoe ❑ Inspection ❑ P/F 1 t�„a" cation ❑ Lo ❑ Service Call ❑ Consultation Certification: ❑ Estimate Reason: i ❑ Labor ElPortable Toilet Rental 1:1 Pump Repair ❑ Waiting Time ❑ Baffle ❑ Repair ' Digging Charge Is Per Driver Discretion r ❑ Chemical Treatment. % o ❑'Other �- Description of Work . ycv mdations'"` 'Recomen. ��rms'o�Pay�rhe�� j' Parts r�r Wacuum Pumping Drain,C/leaning -� / s` --.J r !° Yr/.�Gi ` 1 / / Month (! Yr. r � E�T;,3O�,DFAYS/Tax ! f' 1. � �� ' � r f. � �� r .,� t ��. Discount Terms & Conditions _--------- — ^ / ❑ :Cash . ❑ Check ❑ Credit` d �i�� L�7 fir! it o%total 1. Not responsible for damage beyond curb line. t 3. 1.5./ per month will be charged to accounts past due." 'beyond 2. All complaints shall be reported within 48 hours. j /�4,.The purchaser agrees to pay all cost of collection. c� Customer Signature Serviceman SEPTIC SYSTEM INSPECTION FORM ADDRESSC� DATE INSPECTEDglo PROPERLY FliNCTIONING?Y) N WEATHER CONDITIONS COMMENTS: WATt ER. QLAL1 i y TESTI ET�, 2 ReSOL- i S? DYE TEST PERFORMED? Y N DATE? SKETCH: WATERSHED RESIDENTS QUESTIONNAIRE 1. Name P-6 l3 02t W CZ -25 s 7&72- 2. & 22. Street Address 6-o O3. How many members are in your household? 4. What type of sewage disposal system do you have? ❑ cesspool Vseptic tank and leaching area ❑ connection to municipal sewer ❑ other (describe) ❑ do not know 5. Are the plans (drawings) forryour sewage disposal system on file with the Board of Health? ❑ yes ❑ no do not know --- 6. How old is your sewage disposal system? ❑ 0-5 years ❑ 6-10 years P-1-11-20 years=f ❑ over 20 years ❑ do not know 7. Has your sewag disposal system been rebuilt or repaired? El yes [no ❑ do not know If yes, approximately how long ago? years. What was done? 8. H�o�'� frequently is your sewage disposal system pumped out? ❑ annually every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never 9. Have you had any problems with your sewage disposal system? ❑ yes g?"'no If yes, what problems? - --- ❑ repeated pump -outs needed ❑ system clogs, backs up, or drains slowly ❑ odors ❑ sewage surfaces through ground 10. How many of each appliance are connected to your sewage disposal system? washing machine dishwasher 1 garbage disposal dehumidifier drain sump pump toilet roof/pavement drains shower/bathtub _ 11. Please state the brand and type (liquid or pdwder) of detergent you use for: dishwasher clotheswasher — / 12. Does your property have a lawn? L�' yes ❑ no If yes, approximately what size? ❑ less than 1/4 acre ❑ 1/4 acre ❑ 1/2 acre ❑ 3/4 acre acre ❑ more than 1 acre (Specify) acres 13. How often do you fertilize your lawn? No. of applications per year 71 Season(s) of the year rte/ O14. Please state the brand and type (liquid or granular) of lawn fertilizer you use: 2( Check here if your lawn is maintained by a professional landscape contractor. _- _ _ - -------------