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� J <br />Ende Septic Service, LLC <br />24910 Territorial Road - Rogers, MN 55374 <br />Phone: 763-428-4489 - e-mail: info(,)endeseptic.com <br />Maintenance inspection Form <br />MPCA License #: L2654�� /% MI-D" <br />ai t ' er name: ❑ Tristan k Brandon ❑ Scott <br />/. _ t �/_ � I—I rivinn I—I iCain <br />Date: �� _ '20 <br />Invoice <br />Name: .fV"' <br />Maintenance hole cover is <br />Description: <br />Address: t <br />Total Cost of Service: Z w <br />City/State/Zip: © <br />Payment Mcthod: ❑ Check ❑ Cash ❑ Credit <br />Tank (check if present) <br />Tank leaks below the <br />Tank leaks above the <br />Maintenance hole cover is <br />❑ Structural integrity <br />designed operating <br />designed operating <br />damaged, cracked, <br />❑ Risers leaking <br />depth <br />depth <br />unsecured, or appears to be <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />structurally sound <br />Septic/holding Tank #1 <br />❑ Yes A"qLNo <br />❑ Yes .�l No <br />❑ YesNo <br />17 <br />Gallons: <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />D( Septic/holding Tank #2 <br />❑ Yes I No <br />❑ Yes f�No <br />❑ Yes -IR No <br />Gallons: <br />Cleaned? ❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes .0 No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />4R Pump Tank <br />❑ Yes 4�.No <br />❑ Yes PNo <br />❑ Yes A\No <br />Gallons: <br />Did you measure the accumulation of scum and sludge? A Yes ❑ No <br />If the maintenance hole was used, were covers secured in place? es ❑ 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 1_No <br />Tank #2 ❑ YesOKLNo <br />Pump Tank ❑ Ye No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Mound <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Risers leaking <br />Q_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: ❑ Yes -T-'SNo Next Set -vice: 0 1 yr 0 2 yr C+FQP'_3 yr <br />