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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(aendeseptic.com <br />0 Maintenance ❑ Emergency ❑ Other <br />Maintenance Inspection Form <br />❑ Tristan R Brandon ❑ Scott ❑ Kurt ❑ Robert <br />Disposal location: ❑ Land ap ❑ Treatment plant <br />Date: 5— O — d 7 <br />Invoice <br />Name: (ac b &r- Asa i� <br />Description: <br />Address: 4 S 6 t I cam¢,. Fd <br />Total Cost of Service: <br />City/State/Zip: Q forNo <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 />❑ St rural integrity <br />designed operating <br />designed operating <br />damaged, cracked, <br />❑ Riser eaking <br />depth <br />depth <br />unsecured, or appears to be <br />❑ Baffles <br />❑ <br />El Baffles <br />structurally sound <br />)I Septic/holding Tank #1 <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />❑ Non-domestic ste <br />❑ Ponding/surfacing <br />Septic/holding Tank #2 <br />❑ ❑ No <br />❑ ❑ No <br />❑ ❑ No <br />Gallons: <br />❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yeso <br />❑ Yes do <br />ElYes NO <br />Gallons: <br />Tj4 Pump Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />Did you measure the accumulation of scum and sludge? %Yes ❑ No 10% <br />Access point: ❑ Cover/maintenance hole; if so, were covers secured in place? ❑ Yes ❑ No <br />Access point: ❑ Inspection pipe; if through pipe, did homeowner sign off ? ❑ Yes ❑ 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 covers, etc.? If so, explain in comments below. <br />#1 ❑ Yes ❑ No <br />ank #2 ❑ Yes ❑ No <br />mp Tank ❑ Yes ❑ No <br />S in <br />❑ St rural integrity <br />❑\En-dome'c <br />❑ St tural integrity <br />❑ Moun <br />❑ Riser eaking <br />❑❑ <br />Risers aking <br />❑ Elevated infield <br />❑ Baffles <br />❑ <br />El Baffles <br />❑Pressure be <br />❑ Non -dome waste <br />❑❑ <br />Electrical is s <br />❑ Trenches <br />❑ Non-domestic ste <br />❑ Ponding/surfacing <br />❑ Effluent filter clea d? <br />❑ Other: <br />❑ Yes ❑ No <br />Comments: 3 4ert.r OLd <br />m he <br />h9 my e . <br />Nofi Y try Ofb )�,-c <br />�) Lrrl Ptd <br />/ a i7o <br />