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Ende Septic Service, LLC, MPCA Lie #L2654 <br />24910 Territorial Road • Rogers, MN 55374 <br />❑ Tristary Brandon <br />Ll <br />Phone: 763-428-4489 <br />email: info(ci,)endeseptic.com <br />kMaintenance ❑ Emergency ❑ Other <br />Maintenance Inspection Form <br />❑ Scott ❑ Dylan ❑ <br />Disposal location:ikLand ap ❑ Treatment plant <br />Date: <br />Invoice <br />Name: d 1 h ne/ <br />/ <br />Description: 3 �r� i—('o0 • c- %�v C / <br />Address: 333, ! Q111 / ,, <br />Total Cost of Service: <br />City/State/Zip: <br />Payment Method: ❑ 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 />ASeptic/holding Tank #1 <br />❑ Yes <No <br />❑ Yes 'ANO <br />❑ Yes(�1 No <br />Gallons: ow � <br />❑ Non-domestic waste <br />l <br />LL <br />!�s Septic/holding Tank #2 <br />❑ Yes q No <br />❑ Yes e�No <br />❑ Yes -7 No <br />Gallons: <br />❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />�QPump Tank <br />❑ Yes ANO <br />❑ Yes .ANO <br />❑ Yes -ff�No <br />Gallons: <br />Did you measure the accumulation of scum and sludge? VYes ❑ No <br />Access point: Dover/maintenance hole; if so, were covers secured in place? 'OK Yes ❑ No <br />Access point: B-hrspection pipe; if through pipe, did homeowner sign off ? $*es---B-Pio-- <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 ❑ YesAYNo <br />Tank #2 ❑ Yes, K_'No <br />Pump Tank ❑ YeA' No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />ALMound <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 />