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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 7634284489 • e-mail: info(eiendeseptic.com <br />MPCA License #: L2654 <br />Maintenance Inspection Form <br />Maintainer name: ❑ Tristan ❑ Brandon ❑ Scott <br />A!PD lan ❑ Keven <br />Date: 3'2, <br />Invoice <br />Name: <br />Description: <br />Address: <br />Total Cost of Service: <br />City/State/Zip: iPaymentMethod: <br />❑ 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 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 />PWSeptic/holding Tank #1 <br />❑ Yes -@?No <br />❑ Yes Mo <br />❑ Yes �Mo <br />Gallons: l <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />,Wteptic/holding Tank #2 <br />❑ Yes ;►No <br />❑ Yes —VNo <br />❑ Yes -PIo <br />Gallons:v <br />Cleaned? ❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />``Pump Tank <br />❑ Yes tg'No <br />❑ Yes .0 -No <br />O Yes bio <br />Gallons: -!UIJ <br />Did you measure the accumulation of scum and sludge? W -Yes ❑ No <br />If the maintenance hole was used, were covers secured in place? oElYes ❑ 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 .@Mo <br />Tank #2 ❑ Ye&AVNo <br />Pump Tank ❑ YG&-O-W <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />41FMound <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Risers Ieaking <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 -lb yr <br />