350 North Arm Lane Maintenance Inspection form Aug 2023

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Jim Eicher D Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 _I--1 91 Maintenance Inspection Form MPCAL4286 Maintainer 0 Jim [� Duane Nick • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net UMI L 4 I 1— — ✓ Pumping Fee: j, .,_4�- Name: `� tJ Long Pull Fee: Address: Other Repairs: City/State/Zip: 3 V �• / lHlb� Total Cost of Servic Payment Method: ❑ Check ❑ Cash -Credit Maintenance hole cover Is damaged, Tank (check if present) Tank leaks below the designed operating depth Tank leaks above the designed operating depth cracked, unsecured, or appears to be structural) unsound LI'Septic/holding Tank #1 ❑ Yes No ❑ Yes ❑ Yes No Gallons: t ,V (A Septic/holding Tank #2 0 No ❑ Yes 01110 Gallons: 1 ZS 0 ❑ Yes ❑ No ❑ Yes ❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: ump Tank ❑ Yes FA/0 ❑ Yes o ❑ Yes P'No Gallons: i 2.S'``� How Accessed Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: ason For Pumping: �'%.A- ❑ Other (see attached) ❑ Yes C:Ied es' ❑ No `�1'` Did you Identify any operational Issues or unsafe conditions while assessing the sewage tanks In this system, I.e., .,t_ 7 rF— Whin in __MPnh 0InW_ Tank #1 ❑ Yes No Tank #2 ❑ Yes DIN o Pump Tank ❑ Yes No System ❑ Structural integrity ❑ Structural Integrity ❑ Structural integrity DIVIound ❑ Elevated drainfield ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Pressure bed ❑ Baffles ❑ Non -domestic waste ❑ Baffles ❑ Non -domestic waste ❑ Baffles ❑ Electrical Issues ❑ Trenches ❑ Non -domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑ Yes ❑ No Comments: niGnnsaL ❑ Land Application: hr Wastewater i reatment riant w-vt 1-w- - Disposal Site: Lime: Gallons Z oe Plowed: ❑ Yes ❑ No Time: Temperature: pH: > 12 ❑ Time: Temperature: pH: > 12 0