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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 />MPCA License #: L2654 Maintainer name: ❑ Tristan Brandon ❑ Scott <br />Maintenance ❑ Emer ency ❑ Other <br />LJDvlan ❑ <br />Date: <br />Invoice <br />Name: h <br />Description:o�' d S , ,- <br />Address: t'/ S <br />otal Cost of Service: r/ $ 3 O • a <br />City/State/Zip: <br />Payment M thod: heck ❑ Cash ❑' Credit <br />d� <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 />❑ Baines <br />structurally sound <br />Al Septic/holding Tank #1, . <br />❑ Yes (Ie'No <br />❑ Yes No <br />❑ Yes No <br />Gallons: 2205dI <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />Septic/holding Tank #2 <br />❑ Yes "o <br />11Yes No <br />11Yes No <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 No <br />11 Yes No <br />El Yes ki No <br />Gallons: <br />Did you measure the accumulation of scum and sludge? <br />If the maintenance hole was used, were covers secured in place? <br />;Yes 11 No <br />J�`4`,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 toners, etc.? If so, eeplain in comments below. <br />Tank #1 El Yes No <br />Tank #2 ❑YeskNo <br />Pump Tank ❑ YeACNo <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />46mound <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Elevated drainfield <br />❑ Baffles <br />❑ Baffles <br />❑ Baines <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: IIGS-- \\ 5Q/'l/j e /�e'C �t/1z m/J <br />GJt! /WorJf�'o w� <br />,� �ts,ll <br />Is a mound cleaning recommended at this time: ❑ Yes 4tNo Next Service: ❑ 1 yr 0 2 yrV yr <br />