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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-428-4489 • e-mail: info(a)endeseutic.coin <br />MPCA License #: L2654 <br />Maintenance Inspection Form <br />Maintainer name: ❑ Tristarl*Brandon ❑ Scott <br />❑ Dvlan ❑ Keven <br />Date: <br />Invoice <br />Name: Q,� <br />Description: <br />�ddtess: <br />Total Cost of Service: <br />Citotatc <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />TAnk:(Chook if present) <br />Tank leaks below the <br />Tank leaks abovelthe. <br />Wlaintenance'UIq.aeov0 r 4, <br />❑ Structural integrity <br />designedmerating <br />designed operating <br />Alin iye' , er <br />❑ Risers leaking <br />depth <br />depth <br />ausecarei;oappefirll be <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />s&.uctt i ily >341 <br />OSeptic/holding Tank #1 <br />❑ Yes KNo <br />❑ Yes kNo <br />❑ Yes &o <br />Gallons: < <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />['Septic/holding Tank #2 <br />❑ Yes 4No <br />❑ Yes Flo <br />❑ Yes $2fN0 <br />Gallons: <br />Cleaned? ❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />Pump Tank <br />❑ Yes 4Z.Wo <br />❑ Yes .0 -No <br />❑ Yes . jANo <br />Gallons: <br />Did you measure the accumulation of scum and sludge? jqYes ❑ No <br />If the maintenance hole was used, were covers secured in place? Ayes ❑ No <br />Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., <br />cracked tanks, missing baffles, broken covers, etc.? If so, explain in comments below. <br />Tank #1 ❑ Yes C"o <br />Tank #2 ❑ Yes jo:bio <br />Pump Tank ❑ Yes 611$�o <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 C7' No Next Service: 0 1 yr 0 2 yr ,^Tyr <br />