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Ende Septic Service, LLC, MPCA Lic #L2654 Maintenance Inspection Form <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763.4284489 ❑ Tristan � Brandon ❑ Scott ❑ Zach ❑ Robert <br />email: info(dendeseotic.com <br />❑ Maintenance ❑ Emergency ❑ Other . DispoW location: ❑ Land ap *! T eatment plant <br />Date: — — ZS' <br />Invoice <br />Name: ;t <br />Description: <br />Address: / � t V �� ,� <br />Total Cost of Service: ?sue 00 <br />City/State/Zip: lnoKely <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 No <br />❑ Yes [ No <br />❑ Yes Or -No <br />Gallons: <br />Septic/holding Tank #2 <br />❑ Yes? No <br />❑ Yes ,�i No <br />❑ Yes No <br />/ Gallons: <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />47 Pump Tank <br />❑ Yes 4No <br />❑ Yes Al No <br />❑ Yes 4NO <br />Gallons: <br />Did you measure the accumulation of scum and sludge? 0 Yes ❑ No <br />Access point: Cover/maintenance hole; if so, were covers secured in place? VYes ElNo <br />Access point: spection pipe; if through pipe, did homeowner sign off %-Beres-- 5-Nu <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 14 No <br />Tank #2 ❑ Yes @No <br />Pump Tank ❑ YesN.No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />I_Mound <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 cleaned? <br />❑ Other: <br />❑ Yes ❑ No <br />Comments: <br />