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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 Maintenance Inspection Form <br />Phone: 763-428-4489 • e-mail: info(a,endeseptic.com <br />MPCA License #: L2654 Maintainer name: 0 Tristan ❑ Brandon ❑ Scott <br />Dvlan ❑ Keven <br />Date:,, <br />Invoice <br />Name: <br />Description: <br />Address: <br />Total Cost of Service: <br />City/State/Zip:` ,)item t-) <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />Tank (check if present) <br />Tank leaks below the <br />Tank leaks above the <br />Maintenance hole cover is 4 <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 />.JB' Septic/holding Tank #1 <br />❑ Yes t fNo <br />❑ Yes ❑-No <br />❑ Yes JDWo <br />Gallons: <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />Septic/holding Tank #2 <br />❑ Yes allo <br />❑ Yesal to <br />❑ Yes ' to <br />Gallons: <br />Cleaned? ❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes 0 No <br />0 Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />e.0 Pump Tank <br />0 Yes F No <br />❑ Yes [a No <br />❑ Yes 0—No <br />Gallons:�/ r <br />Did you measure the accumulation of scum and sludge? 0 Yes 0 No <br />If the maintenance hole was used, were covers secured in place? J;aYes ❑ 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 BNo <br />Tank #2 ❑ Yes i No <br />Pump Tank ❑ Yes i No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />,!TMound <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 0 No Next Service: 0 1 yr 0 2 yr Q!3 yr <br />