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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763428 1489 • e-mail: infoCcimdeseptic.com <br />MPCA License #: L2654 <br />Maintenance Inspection Form <br />Maintainer name: ❑ Tristan4flrandon ❑ Scott <br />❑ Dvlan ❑ Keven <br />Date: .- <br />Invoice <br />A. J of. <br />Description: <br />Address. ., 'Cl <br />Total Cost of Service: f <br />City/�ta#e/ipt .: <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />Tank {check if present) <br />Tank'kaks below the <br />Tank leeks above the <br />Malnte"Ia kiti,�.c : i$` <br />❑ Structural integrity <br />designed operating <br />designed operating <br />damagit;-.''ed.'.: <br />❑ Risers leaking <br />depth-' <br />depth <br />unset`ed„+RKp!so bye <br />co <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />strHCtili'llljrs(11#i�d <br />,%.Septic/holding Tank #1 <br />❑ Yes 01 No <br />❑ Yes K No <br />❑ Yes M(No <br />Gallons: 1500 <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />)9.$eptic/holding Tank #2 <br />❑ Yes K No <br />❑ Yes A No <br />❑ Yes AjVo <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 UgNo <br />❑ Yes M No <br />❑ Yes 1ENo <br />Gallons: <br />Did you measure the accumulation of scum and sludge? )Yes ❑ No <br />If the maintenance hole was used, were covers secured in place? -JLYes ❑ 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 A�10 <br />Tank #2 ❑ Yes^No <br />Pump Tank ❑ YesA1No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />WC -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: ❑ Yes ❑ No Next Service: 0 1 yr 0 2 yr k3 yr <br />