Laserfiche WebLink
Ende Septic Service, LLC, MPCA Lic #L2654 <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763428-4489 <br />email: infopendeseptic.com <br />Maintenance Inspection Form <br />❑ Tristan kBrandon ❑ Scott ❑ Zach ❑ Robert <br />PyC Maintenance ❑ Emergency ❑ Other l isppya] location: ❑ Land ag-k r atment plant <br />Date: <br />Invoice W• ;J, <br />Name <br />IomlwO <br />Description. S. `V �Lo lw// <br />Address: <br />r <br />Total Cost of Service &Z'C-7 2 <br />City/State/Zip: <br />Rat'vJ <br />" <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 />�" <br />❑ Yes a 0No <br />❑ Yes to <br />❑ Yes I No <br />t Gallons: s' <br />Septic/holding Tapk #2 <br />❑ Yes fp No <br />❑ Yes I�No <br />❑ Yes OkNo <br />Gallons: <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />Pump Tank <br />❑ Yes A No <br />❑ Yes A -No- <br />❑ Yes 0?'No <br />f Gallons: <br />Did you measure the accumulation of scum and sludge? Yes ❑ No <br />Access point: Cover/maintenance hole; if so, were cover secured in place? <Yes ❑ No <br />Access pointrB'bispection pipe; if through pipe, did homeowner sign o <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 No <br />Tank #2 ❑ Yes No <br />Pump Tank ❑ 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 />❑ Elevated drainfteid <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 />