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04-12-2021 Septic Pumping Report
Jim Eicher D Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE 4-i-)- 7 l Maintenance Inspection Form MPCA Lic. # 654 Maintainer D Jim O Duane IP Nick • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net Pumping Fee: � Maintenance Holes Securely Replaced: Name: - S> • •\ '"" a fit, r Nov r vw&- Long Pull Fee: I ❑ Risers leaking ❑ Risers leaking Ad ress: ❑ Elevated drainfield ❑ Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed ❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical issues (� � Other Repairs: _ ❑ Ponding/Surfacing City/State/Zip: ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑Yes []No Nm t'o Comments: — - t— Total Cost of Service: 7��c yxiC Payment Method: ❑ Check ID -Cash ❑ Credit 3 aS oo Tank (check If present) Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, designed operating depth designed operating depth cracked, unsecured, or appears to be CTI ptic/hoiding Tank #1 structurally unsound Gallons: ❑ Yes 'No ❑ Yes ( ❑ Yes et rVo eptic/holdi0 Tank #2 j Gallons: o ❑ Yes 0 No ❑ Yes C�o ❑ Yes Q No ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ump Tank Gallons: t �,� ❑ Yes � "� o ❑ Yes Ca'No ❑ Yes RrNo How Accessed: EWaintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: El Other (see attached) ❑ Yes L3'No Ble s ❑ Ni .� . Did you Identify any operational Issues or unsafe conditions while assessing the sewage tanks /n this system, Ie., [racked tanke- micelnn haB9ne hmLnn .,...a .�' I rs, t— Tank #1 ❑ Yes QXo Tank #2 ❑ Yes o Pump Tank ❑ Yes o System ❑ Structural Integrity ❑ Structural integrity ❑ Structural Integrity ound ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield ❑ Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed ❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical issues ❑ Trenches ❑ Non-domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑Yes []No Comments: — - t— Disposal: ❑ Land Application: ❑ Wastewater Treatment Plant Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No Time: Temperature: pH: >12 ❑ rime: Temperature: pH: >12 ❑ .-•t � � 1•� • Q '1�.-ter. C� � 'A� � •'� Sim•�-�, �.r-� shy ...r•-.'\� ��.;, � �•�,� �'--��-