4780 North Arm Drive West - Septic Pumping Report

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DVANE*� Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 nerI: S-' S- Z.'5' Maintenance Inspection Form MPCA Lic. #L4286 Maintainer 0 Jim Nick Sam • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Pumping Fee: Name: V Address: 4 L( S S Long Pull Fee: Other Repairs: City/State/Zip: �V-0V'_D Total Cost of Sei -� L Payment Method: ❑ Check ❑ Cash ❑ Credit aw 0H Tank leaks above the Maintenance hole cover is damaged, cracked, unsecured, or appears to be nk leaks below the Tank (check fined operating depth designed operating depth structural) unsound Septic/holding Tank #1 El Yes No El Yes Cl No El Yes 2-6-0 Gallons: (3 iT� Septic/holding Tank #2 ❑ 'No Yes C� ❑Yes C1 No El Yes No Gallons: t 5 ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Pump Tank ❑ Yes C" No ❑ Yes Z No ❑ Yes Z No Gallons: r 0-0 How Accessed: Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: El Other (see attached) PlYes ❑ No I -I es ❑ No '.� Did you identiy(�� any operational issues or unsafe condltions while assessing the sewage tanks in this system, i.e., /_—&—i tin Le ,« ., r,arfroc hr Lron �nvarc etr_ 7 ff sn. explain in commentsi166elow. Tank #1 ❑ Yes En No Tank #2 ❑ Yes No Pump Tank ❑ Yes E^o System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity Mound ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield ❑ Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed ❑ Non -domestic waste ❑ Non -domestic waste ❑ Electrical issues ❑ Trenches ❑ Non -domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑ Yes ❑ No Comments: Disposal: ❑ Land Application: Z'Wastewater Treatment Plant W Disposal Site: Lime: Gallons 2'7 60 Plowed: ❑ Yes ❑ No Time: Temperature: pH: > 12 ❑ Time: Temperature: pH: > 12 0 I .— ME:- 0,61 ON, w; mm, - — W-1-oo 01 1