PUMPER’S REPORTPUMPER' S REPORT
THURSTON COUNTY
SINCE IBS3
Tax Parcel #
Owners Name
Date of Service ~~ C,. ~ ~ - ate. 00 ~c
Site Address ~Jr03(c ~~ W y SO ~ sE City Zip 5~9
SEPTIC TANK
Septic Tank Exposed for Inspection? [/j ES [ ] NO If no, explain
Estimated Tank Size ~ ~ ~ o Gallons Pumped // e c Compartments .?
Bottom/sides in Good Condition (no cracks/holes) [ ]YES [ ] NO If no, explain
Tank Repairs Made? [ ]YES (] NO If no, e
Type of Tank? ~ T
BAFFLES
Baffle Wa1lsNents Cleaned Inlet
Conditions of Inlet Baffle Good
Conditions of Outlet Baffle Good
FLUID LEVELS
Fluid Levels Normal in First Compartment?
Fluid Levels Normal in Second Compartment?
Effluent Running Back into Tank from Drainfleld?
SEPTIC TANK COMMENTS
ROCKLAN SEPTIC SERVICE, INC.
b~ P.O. Box 5574
LACEY, WA 98509
TEL: (360) 491-9459
FAX: (360) 273-7423
[ ] Center ( t [ ]
~ FOR ~I~~ONMEI~ ~ [ ]
[ ]YES [ ] NO If no, explain
] R TANK DO ~~t
Screened [ ]
PUMP CHAMBER (if applicable)
Pump Chambers Exposed for Inspection? [ ]YES (] NO If no, explain _
Pump (tank) Pumped Out? [ ]YES [ ] NO If no, explain _
Pump (tank) Good Condition? [ ]YES O
Condition of Pump ~ ~MENT ] of Working ,~ `~
Is the Pump Screened? FOR TANK A O 'v
Screen [ ]Plugged [ ]Cleaned
PUMP CHAMBER COMMENTS
Findings snd determinations of this Inspection reflect conditions ae they existed on the day the septic tank wea pumped. No claim la made
by this company, either expressed or Implied, concerning success or failure of the septic system.
Pumper Signature Date