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Ende Septic Service, LLC, MPCA Lic #L2654 <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-428-4489 <br />email: info(a)endeseptic.com <br />Maintenance Inspection Form <br />❑ Tristan 1k Brandon ❑ Scott ❑ Zach ❑ Robert <br />Ka Maintenance ❑ Emergency ❑ Other. Disp�dl location: El Land ap eatment plant <br />-Z ( _ -1kY IMn n !i'ln <br />Date: 9� 15-- 2-5- <br />Invoice <br />r <br />Name: <br />Description: y �o <br />YO <br />Address: S I <br />Total Cost of Service:051-- <br />City/State/Zip: <br />0. <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 ,1 No <br />Gallons: <br />I Septic/holding Tt #2 <br />El ®No <br />❑ Yes ZsNo <br />El Yes No <br />Gallons: <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />6 Pump Tank <br />❑ Yes A -No <br />❑ Yes 6*0 <br />❑ Yes AN -No <br />Gallons: boo <br />Did you measure the accumulation of scum and sludge? WYes ❑ No <br />Access point: Qf Cover/maintenance hole; if so, were covers secured in place? O(Yes ❑ No <br />Access point- B'ihspection pipe; if through pipe, did homeowner sign off` ego <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 ANo <br />Tank #2 ❑ Yes .kNo <br />Pump Tank kYes �`No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />kMound <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 />q93 Electrical issues <br />❑ Trenches <br />❑ Non -domestic waste <br />❑ Ponding/surfacing <br />❑ Effluent filter cleaned? <br />❑ Other: <br />❑ Yes ❑ No <br />Comments: r Ownt, *V- ZLh& r `-JQS [5 I <br />�`G.Y'yti 110� CJ.O\n5 GF`E_. <br />