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Ende Septic Service, LLC, MPCA Lic #L2654 <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-4284489 <br />email: infopendeseptic.com <br />Maintenance Inspection Form <br />❑ Tristan J� Brandon ❑ Scott ❑ Zach ❑ Robert <br />Maintenance ❑ Emergency ❑ Other �I� Dispp�l location: ❑ Land ap,& T atment plant <br />Date: <br />Invoice <br />Name: <br />Description: 522 <br />Address: C 9x r, v <br />Total Cost of Service: S DO <br />City/State/Zip: Oro ko <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, or appears to be <br />structurally sound <br />Septic/holding Tank #1 <br />❑ Yes I No <br />❑ Yes No <br />❑ Yes I.No <br />Gallons: p <br />Septic/holding Tank #2 <br />❑ Yes �] No <br />❑ Yes '�No <br />❑ Yes 01 No <br />Gallons: <br />\ <br />r <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />Ofump Tank <br />❑ Yes 19.No <br />❑ Yes OKNo <br />❑ Yes A No <br />Gallons: <br />Did you measure the accumulation of scum and sludge?.biYes ❑ No <br />Access point: cM,,Cover/maintenance hole; if so, were covers secured in place? ^Yes ❑ No <br />Access poinF.-17'lnspection pipe; if through pipe, did homeowner sign offs"—❑ res� <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 ICNo <br />Tank #2 ❑ Yes J8,No <br />Pump Tank ❑ Yes JANo <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 />�Nqp-domestic waste <br />❑ Non -domestic waste <br />❑ Electrical issues <br />❑ Trenches <br />W(�c� <br />❑ Non -domestic waste <br />❑ Ponding/surfacing <br />d <br />❑ Effluent filter cleaned? <br />❑ Other: <br />❑ Yes ❑ No <br />Comments: east h fl uS l re S <br />