HomeMy WebLinkAbout2325 Colorow Rd - 210724101008Eagle County OWTS Systems Cleaners Reporting Form
NOTE: Required to be submitted to Environmental Health within 10 days of cleaning an OWTS
s sy tem
C
EAGLE COUNTY Systems Cleaner Company i��c �Ju.� 86 4�WR� ,l License Number
Email Address ✓ Phone
Service Technician
Tax Parcel #
Address of Service k,�, 5 05
Person Requesting Service( b .��%K C-S Phone ` 7f)rQ�
Property OwnerOlh6i a Phone
Septic System Permit
Date of service
Sewage Disposal
Tank Size r/800
Tank Material nJLa=drl
General Condition and Functionality of the System
Recommended Repairs J;?`Y�
Site sketch showing location of the septic tank access lids measured from at least 2 fixed points
(Photos Encouraged)
Op.
U Signed
"I� 4
_ Date
