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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-428-4489 • e-mail: info(iuendesepticxom <br />MPCA License #: L2654 <br />Maintenance Inspection Form <br />Maintainer name: ❑ Tristan�WBrandon ❑ Scott <br />❑ Dylan ❑ Keven <br />Date: L4 - 3b . ( 4z� <br />Invoice <br />Name: r (<AI M <br />Description: <br />Addr"5- <br />Total Cost of Service: <br />City/State/Zip: OY70 Mt•3 <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />Taialt (check if present) <br />Tank leaks below the <br />Tank leaks above the <br />Maintenance 41 .!i cover Is <br />❑ Structural integrity <br />designed operating <br />designed operating <br />daxnagedi cracked, <br />❑ Risers leaking <br />depth. <br />depth <br />unsecured, -or. *jppean to. be <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />structureW sound <br />Septic/holding Tank #1 <br />❑ Yes `fpl No <br />❑ Yes V No <br />❑ Yes P No <br />Gallons: L coo <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />.)9 Septic/holding Tank #2 <br />❑ Yes '8 No <br />❑ Yes $2 No <br />❑ Yes flo No <br />Gallons: <br />Cleaned? ❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />W Pump Tank <br />❑ Yes SyNo <br />❑ Yes )i� No <br />❑ Yes PINo <br />Gallons: I MD <br />Did you measure the accumulation of scum and sludge? ❑ Yes %0 No <br />If the maintenance hole was used, were covers secured in place? i4 Yes ❑ No <br />Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., <br />cracked tanks, missing baffles, broken covers, etc.? If so, explain in comments below. <br />Tank #1 ❑ Yes X No <br />Tank #2 ❑ Yes 19 No <br />Pump Tank ❑ Yes 45 No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />Mound <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Elevated drainfield <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />❑ Pressure bed <br />❑ Non-domestic waste <br />❑ Non-domestic waste <br />❑ Electrical issues <br />❑ Trenches <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />❑ Effluent Filter/screen <br />❑ Other: <br />Cleaned? ❑ Yes ❑ No <br />Comments: <br />Is a mound cleaning recommended at this time: 0 Yes `® No Next Service: 0 1 yr 0 2 yr '0 3 yr <br />