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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(a)endeseptic.com <br />Maintenance Inspection Form <br />❑ Tristan i@ Brandon ❑ Scott ❑ Kurt ❑ Robert <br />l� Maintenance ❑ Emergency ❑ Other 4 pop location: ❑ Land ap *Treatmenth plant <br />Date: ct" <br />Invoice <br />Name: A55 Zu -e'" <br />Description: <br />Address: 3 �� - Al Cfjes ✓n <br />Total Cost of Service: <br />City/State/Zip: no <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 />designed operating <br />designed operating <br />damaged, cracked, <br />depth <br />depth <br />unsecured to be <br />orally sound <br />1�Septic/holding Tank #1 <br />❑ Yes of No <br />❑ Yes -IF No <br />❑ Yes t�No <br />Gallons: 116040 'S <br />Al Septic/holding Tank #2 <br />❑ Yes No <br />❑ Yes No <br />❑ Yes No <br />Gallons: <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />lk Pump Tank <br />❑ Yes ONO <br />❑ Yes 6-No <br />❑ Yes A5No <br />Gallons: <br />Did you measur the accumulation of scum and sludge? aYes ❑ No <br />Access point: Cover/maintenance hole; if so, were covers secured in place? AYes ❑ No <br />Access point.-ErV spection pipe; if through pipe, did homeowner sign off <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 []Yes KNo <br />Tank #2 ❑ Yes A No <br />Pump Tank t Yes ❑ No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Mound <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Risers leaking <br />A Elevated drainfield <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />❑ Pressure bed <br />❑ Non -domestic waste <br />❑ Non -domestic waste <br />kElectrical issues <br />❑ Trenches <br />❑ Non -domestic waste <br />❑ Ponding/surfacing <br />❑ Effluent filter cleaned? <br />❑ Other: <br />[]Yes ❑ No <br />Comments: 1 /�/ t'�L s. ~ u /J S D� n5 <br />�wn�G✓R� Ot/Q/'>c C/ GtJ�L^��`/�K� t�l JGKGk/ Ank 0CFdA <br /><C Si"/0�1 c✓G a Owl S� tad Mil <br />/1 c cJ lCloa-� t�JZ l� �4 6a r i $ ��-o <br />iNA "Aa�,„la 4f 3QO co <br />