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04-27-2021 Septic Pumping
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565 Ferndale Road North - 36-118-23-14-0004
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04-27-2021 Septic Pumping
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Last modified
8/22/2023 5:01:43 PM
Creation date
10/27/2021 10:10:30 AM
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x Address Old
House Number
565
Street Name
Ferndale
Street Type
Road
Street Direction
North
Address
565 Ferndale Road North
Document Type
Septic
PIN
3611823140004
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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-4284489 • e-mail: i n fo(i6endesepti c. coin <br />MPCA License #: L2654 <br />Maintenance Inspection Form <br />Maintainer naive: ❑ Tristan ❑ Brandon ❑ Scott <br />4KDvlan ❑ Kevin <br />P or <br />Date: <br />Invoice <br />Name: <br />Description: <br />Address: <br />Total Cost of Service: <br />City/State/Zip: <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 <br />❑ Structural integrity <br />designed vperadng <br />designed operating <br />dan1ag4,ctack4 , . <br />❑ Risers leaking <br />depth <br />depth <br />unsecured; er appears to -be <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />structurally sound <br />49�Septic/holding Tank #1 <br />❑ Yes $No <br />❑ Yes .!I No <br />❑ Yes $No <br />Gallons: <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />Septic/holding Tank #2 <br />❑ Yes *No <br />❑ Yes J fNo <br />❑ Yes XNo <br />Gallons: <br />Cleaned? ❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes O No <br />❑ Yes ❑ No <br />Gallons: <br />oe Pump Tank <br />❑ Yes -PP"No <br />❑ Yes W�No <br />❑ Yes ,# No <br />Gallons: <br />Did you measure the accumulation of scum and sludge? jWYes ❑ No <br />If the maintenance hole was used, were covers secured in place? .Yes ❑ No <br />Didyou 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 f�No <br />Tank #2 ❑ Yes Ato <br />Pump Tank ❑ Yes6No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />AwAound <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Riscrs 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 -03 yr <br />
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