HomeMy WebLinkAbout04-27-2021 Septic PumpingEnde Septic Service, LLC
24910 Territorial Road • Rogers, MN 55374
Phone: 763-4284489 • e-mail: i n fo(i6endesepti c. coin
MPCA License #: L2654
Maintenance Inspection Form
Maintainer naive: ❑ Tristan ❑ Brandon ❑ Scott
4KDvlan ❑ Kevin
P or
Date:
Invoice
Name:
Description:
Address:
Total Cost of Service:
City/State/Zip:
Payment Method: ❑ Check ❑ Cash ❑ Credit
Tank (check if present)
Tank leaks below the,
Tank leaks above the
Maintenance hole cover is
❑ Structural integrity
designed vperadng
designed operating
dan1ag4,ctack4 , .
❑ Risers leaking
depth
depth
unsecured; er appears to -be
❑ Baffles
❑ Baffles
❑ Baffles
structurally sound
49�Septic/holding Tank #1
❑ Yes $No
❑ Yes .!I No
❑ Yes $No
Gallons:
❑ Non-domestic waste
❑ Ponding/surfacing
Septic/holding Tank #2
❑ Yes *No
❑ Yes J fNo
❑ Yes XNo
Gallons:
Cleaned? ❑ Yes ❑ No
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes O No
❑ Yes ❑ No
Gallons:
oe Pump Tank
❑ Yes -PP"No
❑ Yes W�No
❑ Yes ,# No
Gallons:
Did you measure the accumulation of scum and sludge? jWYes ❑ No
If the maintenance hole was used, were covers secured in place? .Yes ❑ No
Didyou identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cracked tanks, missing baffles, broken covers, etc.? If so, explain in comments below.
Tank #1 ❑ Yes f�No
Tank #2 ❑ Yes Ato
Pump Tank ❑ Yes6No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
AwAound
❑ Risers leaking
❑ Risers leaking
❑ Riscrs 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:
Is a mound cleaning recommended at this time: 0 Yes 0 No Next Service: 0 1 yr 0 2 yr -03 yr