Laserfiche WebLink
DUAN�� <br />Septic Service, LLC <br />1205 LaBeaux Ave NE <br />St. Michael, MN 55376 <br />Maintenance Inspection F L4286 <br />rri <br />A Lic. <br />Maintainer <br />Duane <br />Nick <br />• Phone: 763-497-2764 <br />• Email: duaneseptic@centurylink.net <br />INVOICE <br />Ri p% I V •. ( .-- -- <br />Pumping Fee: <br />�j'�� <br />Name: // __� �5 S�� . <br />l <br />C.�v, <br />- e <br />Long Pull Fee: <br />Address: C 2 O C Q <br />/� <br />Other Repairs: �0 <br />City/State/Zip: <br />Total Cost of Service: <br />Payment Method: ❑ Check ❑ Cash <br />❑ Credit <br />A <br />Maintenance hole cover Is damaged, <br />Tank (check if present) <br />Tank leaks below the <br />designed operating depth <br />Tank leaks above the <br />designed operating depth <br />cracked, unsecured, or appears to be <br />structural) unsound <br />Septic/holding Tank #1 <br />❑ Yes <br />BINo <br />❑ Yes Cho - <br />❑ Yes <br />Leo <br />Gallons: /,,-2,j'�D <br />21�e_p_tic/holding jank #2 <br />❑ Yes <br />[J -No <br />❑ Yes ❑INV <br />❑ Yes <br />Gallons: /114a <br />❑ Pretreatment Tank <br />❑ Yes <br />❑ No <br />❑ Yes ❑ No <br />❑ Yes <br />❑ No <br />Gallons: <br />B-ru—mp Tank <br />Gallons: <br />❑ Yes <br />I�'No <br />❑ Yes O No <br />El <br />T.1 No <br />Id y <br />How Accessed: 12,91aintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: <br />❑ Other (see attached) ❑ Yes .11-6— 1 IT ❑ No I -�✓�� <br />Did you Identify any operational issues or unsare conditions while assessing the sewage tanks In this system, I.e., <br />vnhin /n —mantc halaw_ <br />Tank #1 ❑ Yes o <br />Tank #2 ❑ Yes FIMO <br />Pump Tank ❑ Yes o <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 F' en <br />❑ Other: <br />Cleanedt ❑ Yes ❑ No <br />Comments: <br />Disoosal: ❑ Land Application: tJJ Wastewater Treatment Plant <br />Disposal Site: <br />Lime: <br />Gallons <br />Plowed: ❑ Yes <br />❑ No <br />Time: <br />Temperature: <br />pH: <br />> 12 ❑ <br />Time: <br />Temperature: <br />pH: <br />> 12 ❑ <br />gAME <br />,..i.�'� S''''"� .sue- --�"--� ,..�-'�-•. ,,S`'" .s�- <br />