Laserfiche WebLink
Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 Maintenance Inspection Form <br />Phone: 7634284489 • e-mail: info kendese tic.com <br />MPCA License #: L2654 c._ / Mai ntaip�i name: ❑ Tristan*Brandon ❑ Scott <br />t' ❑ DvlanKeven <br />Date: �� -r <br />Invoice <br />Name' <br />Description: <br />OR <br />Address: ` <br />Total Cost of Service. r I :s - <br />designed operating <br />✓� , <br />00.tat e/Zip: <br />Payment Method: .'&. Check ❑ Cash ❑ Credit <br />Tank{che�ckif 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, crack,; <br />❑ Risers leaking <br />depth <br />depth <br />unsecured; or appears to be <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />structurallypnnd <br />*Septic/holding Tank #1 <br />❑ Yes O_ No <br />❑ Yes 00 <br />❑ Yes A%10 <br />Gallons: f <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />Septic/holding Tank #2 <br />❑ Yes .kNo <br />❑ Yes AM <br />❑ Yes "No <br />Gallons: <br />Cleaned? ❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />J%Pump Tank <br />❑ Yes A -No <br />❑ Yes OU -No <br />❑ Yes ),No <br />Gallons: <br />Did you measure the accumulation of scum and sludge? I 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 #] ❑ Yes AN <br />Tank #2 ❑Yes /C.LVO <br />Pump Tank ❑ Yes o <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />4kmound <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 -ONO Next Service: 0 1 yr 0 2 rAtyr <br />