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Ende Septic Service, LLC, MPCA Lic #L2654 <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-4284489 <br />email: info(a)endeseptic.com <br />4 Maintenance ❑ Emergency ❑ Other <br />Maintenance Inspection Form <br />❑ Tristan yBrandon ❑ Scott ❑ Zach ❑ Robert <br />Disposal location: ❑ Land ap T5eptment plant <br />-14 0 Ail 1) MD1 Iti, <br />Date: , <br />Invoice <br />Name: CAKIS 21 �'1+ <br />Description: <br />Address: Ho <br />Total Cost of Service: i 75, 0i- <br />City/State/Zip: ro <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 />1f Septic/holding Tank #1 <br />❑ Yes t�No <br />❑ Yes I(No <br />❑ Yes l No <br />Gallons: 1S6015 <br />60 Septic/holding Tank #2 <br />❑ Yes $I -No <br />❑ Yes LgNo <br />❑ Yes 4KNo <br />Gallons: <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />❑ Pump Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: 6)6}— <br />Do QJ , n,6ov-t- Wt fvow. f *Lc K He 15 vt <br />Did you measure the accumulation of scum and sludge? kYes ❑ No <br />Access point: Cover/maintenance hole; if so, were covers secured in place? Xyes ❑ No <br />Access point:- flnspection pipe; if through pipe, did homeowner sign offa- <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 0 No <br />Tank #2 ❑ Yes No <br />Pump Tank ❑ Yes0,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 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 />