Laserfiche WebLink
Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-428-4489 - e-mail: info(a_?endeseptic.com <br />MPCA License #: L2654 <br />Maintenance Inspection Form <br />Maintainer name: ❑ Tristan ❑ Brandon ❑ Scott <br />AkDvlan nKevPn <br />Date: vlldl�z2 <br />Invoice <br />Name:hnz I(Q <br />Description: <br />Address: M19 RUG <br />Total Cost of Service: <br />City/State/Zip: <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 />❑ Structural integrity <br />designed operating <br />designed operating <br />damaged, cracked, <br />❑ Risers leaking <br />depth <br />depth <br />unsecured, or appears to be <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />structurally sound <br />I? Septic/holding Tank #1 <br />❑ Yes f61No <br />❑ Yes 41n No <br />❑ Yes -9 No <br />Gallons:A'000 <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />itSeptic/holding Tank #2 <br />❑ Yes WN'o <br />❑ Yes J*No <br />❑ Yes jrNo <br />Gallons: anU <br />Cleaned? ❑ Yes ❑ No <br />Com, lletl <br />'RJ Pump Tank <br />❑ Yes if No <br />❑ Yes RfrNo <br />❑ Yes EkNo <br />Gallons: A roe <br />Did you measure the accumulation of scum and sludge? 19 Yes ❑ No <br />If the maintenance hole was used, were covers secured in place? M Yes ❑ No <br />Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, Le., <br />cracked tanks, missing baffles, broken covers, etc.? If so, explain in comments below. <br />Tank #1 ❑ Yes ANo <br />Tank #2 ❑ Yes IF No <br />Pump Tank ❑ Yes JFNo <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />3WMound <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 />❑ Electrical issues <br />❑ Trenches <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />❑ Effluent Filter/screen <br />❑ Other: <br />Cleaned? ❑ Yes ❑ No <br />Comments: <br />Is a mound cleaning recommended at this time: ❑ Yes ❑ No Next Service: 0 1 yr 0 2 yr .4W3 yr <br />