HomeMy WebLinkAbout09-03-2020 Septic Maintenance ReportCnde Septic Service, LLC
24910 Territorial Road • Rogers, MN 55374
Phone: 763-428-4489 • e-mail: info Blend otic ptic.com
MPCA License M L2654
Maintenance Inspection Form
Maintainer name: ❑lTristan%' Brandon ❑ Scott
❑ Dylan ❑ Kevin
Date: 19- ? . -��c"
Invoice
Name: /_. c 0 ri
Description: C
Address:,:t1,.� t r1 (�.`
Total Cost of Service: °hS
City/State/Zip: 6-r' f o
Payment Method:= ❑ Check ❑ Cash ❑ Credit
Tank (check if present)
Tank leaks beloiv the
Tank leaks above the
Maintenance hole cover is
❑ Structural integrity
designed operating
designed operating
damaged, cracked,
❑ Risers leaking
depth
depth
unsecured, or appears to be
Baffles
❑ Baffles
❑ Baffles
structurally sound
Ida Septic/holding'rank #I
❑ Yes Q No
❑ 1'cs .O No
❑ 1'cs i~1 No
Gallons: IZS
h� /�
❑ Non-domestic waste
❑ Ponding/surfacing
OR Septic/holding Tank #2
❑ Yes D No
❑ Ycs ❑ No
❑ Yes -e9,No
Gallons: I Zed
Cleaned? ❑ Yes ❑ No
❑ Pretreatment Tank
❑ Ycs ❑ No
❑ Ycs ❑ No
❑ Ycs ❑ No
Gallons:
QR Pump Tank
❑ Ycs 1 No
❑ Ycs �T] No
❑ Yes A No
Gallons: / Z = (.
Did you measure the accumulation of scum and sludge? V'Yes ❑ No
If the maintenance hole was used, were covers secured in place? kY, es ❑ No
Did you identify any operational issues or unsafe conditions while assessing the selvage tanks in this system, i.e.,
cracked tanks, missing baffles, broken covers, etc.? !f so, evplain in continents below.
Tank #1 ❑ YesLJF No
Tank #2 ,�K7' Ycs ❑ No
Pump Tank ❑ Yes iallo
System
❑ Structural integrity
Q Structural integrity
❑ Structural integrity
AV' Mound
❑ Risers leaking
❑ Risers leaking
❑ Risers leaking
❑ Elevated drainfield
Baffles
❑ Baffles
❑ Baffles
❑ Pressure bed
❑ Non -do estic waste
❑ Non-domestic waste
�p
❑ Electrical issues
❑ Trenches
�e �c t<e
h� /�
❑ Non-domestic waste
❑ Ponding/surfacing
,c
❑ Effluent Filter/screed
❑ Other:
Cleaned? ❑ Yes ❑ No
Comments:
Is a mound cleaning recommended at this time: 0 Yes LI -No Next Service: 0 1 yr 0 2 yr &3 yr