Laserfiche WebLink
Septic Service, LLC <br />1205 LaBeaux Ave NE <br />St. Michael, MN 55376 <br />DATE <br />Pumping Fee: <br />Long Pull Fee: <br />Other Repairs: <br />Total Cost of Se <br />Maintenance Inspection Form <br />MPCA Lic. #L4286 <br />Maintainer 0 Jim <br />"Nick <br />0 Sam <br />• Phone: 763-497-2764 <br />• Email: duaneseptic@centurylink.net <br />INVOICE <br />Name: t " lG u � <br />Address: / - <br />ZED �� <br />City/State/Zip: <br />CD w'- -"-D <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />Tank (check T, errq —_— -- - Below the <br />Tank leaks above the <br />Maintenance hole cover is damaged, <br />cracked, unsecured, or appears to be <br />designed operating depth <br />designed operating depth <br />structural) unsound <br />l�ptic/holding Tank #1 <br />Gallons: [ a�z.� <br />El Yes 9 <br />El Yes �o <br />❑Yes Vo <br />E;�eptic/holding Tank #2 <br />❑ Yes <br />Gallons: t __c,_e <br />No <br />❑ Yes No <br />❑ Yes 4-ft <br />❑ Pretreatment Tank <br />Gallons: <br />❑ Yes ❑ No <br />❑ Yes ElNo <br />❑ Yes ElNo <br />ump Tank <br />❑Yes 2 No <br />❑ Z <br />Gallons: L '- ��' <br />Yes No <br />❑ Yes <br />How Accessed: aintenance Hole <br />Scum/Sludge Measured <br />Maintenance Holes Securely Replaced: <br />Reason For Pumping: <br />❑ Other (see attached) <br />2- es ❑ No <br />�s ❑ No <br />rn'e <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- overs. etc.? Ifso. explain in comments below. <br />Tank #1 ❑ Yes o <br />Tank #2 ❑ Yes 'No <br />Pump Tank ❑ Yes o <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />ound <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/screen <br />❑ Other: <br />Cleaned? ❑ Yes ❑ No <br />Comments: <br />Disposal: 2TGnd Application: ❑ Wastewater Treatment Plant <br />Disposal Site: 1f` l <br />Lime: / <br />Gallons Z-�� <br />Plowed: ❑ Yes <br />EfiiVo <br />Time: <br />2 -7 <br />Temperature: <br />j y, "� <br />pH: j 2_ <br />> 12 ' <br />Time: <br />�iS "� <br />Temperature: <br />( , I <br />pH: <br />> 12 ET <br />�.� Cyr '�t / •�Jt �"� Q� J® '�.-.� Cam• '� / •i� �.`� <br />.,.�'`•�'� �''� sue. �'-' ,✓'`'�'�, �'� ��- <br />