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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763112813489 • e-mail: <br />MPCA License #: L2654 <br />a.I Maintenance ❑ Emcmencv ❑ Other <br />Maintenance Inspection Form <br />C� Ma' tatainer name: 11 Tristan kBrandon ❑ Scott <br />/ / ❑ Dvlan ❑ <br />Date: r ^ Z <br />Invoice <br />Tank leaks above the <br />Name:LAS*- <br />Description:3']� pO —t- <br />tspot <br />Address:o?,319 c W16Lr v <br />Total Cost of Service: <br />�a <br />City/State/Zip: e,2m 14LPayment <br />Method: ❑ Check <br />❑ 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 />Sepdc/holding Tank #1 <br />❑ Yes 4No <br />❑ Yes A�ZNo <br />❑ Yes 4No <br />allons: <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />XSeptic/holding Tank #2 <br />❑ Yes KNo <br />❑ Yes _ No <br />❑ Yes _9No <br />Gallons: <br />Cleaned? [:]Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />tPump Tank <br />11 Yes 2 N <br />11 Yes �10 <br />El Yes AI'No <br />ns: <br />Did you measure the accumulation of scum and sludge? <br />If the maintenance hole was used, were covers secured in place? <br />`q Yes ❑ No <br />Yes ❑ No <br />Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, Le., <br />cracked tanks, missing baffles, broken covers, etc.? ]fso, ewplain in comments below. <br />Tank #1 ❑ Yes cg"'o <br />Tank #2 ❑ YesAMo <br />Pump Tank ❑ Yes -G No <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: ❑ Yes ,<No Next Service: 0 1 yr 0 2 yrs 3 yr <br />