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Ende Septic Service, LLC, MPCA Lic #L2654 <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-428-4489 <br />email: info@1,endeseptic.com <br />Maintenance ❑ Emergency ❑ Other .4nsp ec/tio7 <br />Maintenance Inspection Form <br />❑ Tristan ❑ Brandon ❑ Scott ❑ Dylan ❑ <br />Disposal location: ❑ Land ap ❑ Treatment plant <br />Date: l Z Z <br />Invoice -266 <br />Name: Azr l `j n -f <br />Description: 'Seo ,Q� &OLp / tT <br />Address: 235-QCr hh I r <br />Total Cost of Service: Ov <br />City/State/Zip: v <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />V <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 />Septic/holding Tank #1 <br />❑ Yes �I'No <br />❑ Yes WNo <br />❑ Yes /No <br />Gallons: ss <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />f�Septic/holding Tank #2 <br />❑ Yes PNo <br />❑ Yes ;^0 <br />❑ Yes /zNo <br />/ Gallons: <br />❑ Yes []No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />Pump Tank <br />❑ Yes ; No <br />❑ Yes No <br />❑ Yes /Z No <br />Gallons: <br />1)2 <br />Did you measure the accumulation of scum and sludge?,XYes ❑ No <br />Access point: over/maintenance hole; if so, were covers secured in place? eYes ❑ No <br />Access point: ET107ection pipe; if through pipe, did homeowner sign off 2_.8-Yts—f410 <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 coniments below. <br />Tank #1 Yes ❑ No <br />Tank #2 z4yes ❑ No <br />Pump Tank Xyes ❑ No <br />System <br />❑ Structural integrity <br />❑ tructural 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 cleaned? <br />❑ Other: <br />❑ Yes []No <br />Comments: <br />