HomeMy WebLinkAbout10-04-2021 Septic Pumping reportJim Eicher
D
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
M ATC I . - J/ '7 /
Maintenance Inspection Form
MPCA Lie. # 654
Maintalner D Jim
zDuane
ick
• Phone: 763-497-2764
• Email: duaneseptic(gcenturylink.net
INVOICE
Pumping Fee:
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Long Pull Fee:
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City/State/Zip:
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Cost of Service-
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Payment Method: ❑ Check
❑ Cash
❑ Credit
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Maintenance hole cover is damaged,
Tank leaks below the
Tank leaks above the
cracked, unsecured, or appears to be
Tank (check if present)
designed operating depth
designed operating depth
structurally
unsound
otic/holding Tank #10
Yes
❑Yes filo
❑Yes ❑�^
p� oo
Gallons: Z SD
peptic/holding Tank #2
❑ Yes O'No
❑ Yes Er -93-
❑ Yes
9>a
Gallons: l ZS -L->
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
Gallons:
9-f 21-0 'mp Tank
❑ Yes Cr -No
❑ Yes CNo
❑ Yes
Gallons: i 2try
How Accessed: aintenance Hole Scum/Sludge Measured-fdo i Mainte�nan�ce Holes Securely Replaced: Reason For Pumpin
❑ Other (see attached) ❑ Yes ❑" es ❑ No T-Vk0' _
Did you identify any operational issues or unsafe conditlons while assessing the sewage tanks In this system, I.e.,
c cked tanks, missing baffles, broken covers, etc.? If so, explain in comments below.
Tank #1 ❑ Yes o Tank #2 ❑ Yes o Pump Tank ❑ Yes 2rNo System i
❑ Structural integrity ❑ Structural integrity ❑ Structural Integrity ound I
❑ Risers leaking ❑Risers leaking ❑ Elevated drain
❑ Risers leaking g !
❑ Baffles ❑ Baffles ❑ Battles ❑Pressure bed
❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical Issues ❑ Trenches
❑ Non-domestic waste ❑ PondinglSurtacing
❑ Effluent Filter/screen ❑ Other:
_L Cleaned? ❑ Yes ❑ No
Comments:
Disposal: ❑ Land Application: ❑ Wastewater Treatment Plant
Disposal Site: Lime: Gallons Plowed: ❑ Yes C
Time; Temperature: pH:
Time: Temperature; pH: