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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 Maintenance Inspection Form <br />Phone: 763-4284489 • e-mail: <br />MPGA License #: 1,2654 Maintainer n, me: 171Tristan randon ❑ Scott <br />�17 <br />Maintenance ❑ Emergency ❑ Other / �1 I , ❑ Dylan ❑ <br />Date: 6,- - 7 <br />Invoice <br />Se_"V i <br />Name: CCf1 �'"Gt t,-� y./^ <br />Description: ►%S ��©-t 97. Std �y,s <br />Xr. c f <br />Address: 1 <br />Total Cost of Service: 66._" z <br />❑ Risers leaking <br />City/StatelZip. 6 f If <br />Payment Method: ❑ Check ❑ Cash <br />❑ Credit <br />Tank (cheek 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 />Septic/holding Tank #1 <br />❑ Yesr o <br />❑ Yes o <br />❑ Yes _l No <br />allons: t'i6 <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />Septic/holding Tank ##2 <br />❑ Yes 4No <br />❑ Yes No <br />❑ Yes AA No <br />Gallons: <br />Cleaned? ❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />A -Pump Tank <br />❑ Yes ANo <br />❑ Yes ANO <br />❑ Yes A?LNo <br />Gallons: t <br />Did you measure the accumulation of scum and sludge? Yes ❑ No <br />If the maintenance hole was used, were covers secured in place? Yes ❑ No <br />Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this systens, i.e., <br />cracked tanks, missing baffles, broken covers, etc.? rfso, explahs in cornments below. <br />Tank #1 ❑ Yes kNo <br />Tank #2 ❑ Yes o <br />Pump Tank ❑ Yes o <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />VMound <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 />❑ lslectrical 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 l No Nest Service: 0 1 yr 0 2 yr * yr <br />