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HomeMy WebLinkAbout09/09/2021 Septic Pumping ReportSeptic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 r)ATF L 1'�-' 1 Maintenance Inspection Form MPCA Lic. # 654 Maintainer Jim O Duane "Nick .ori ���1 • Phone: 763-497-2764 a ��± w"e- A `� • Email: duaneseptic@centurylink.net Pumping Fee:1-3z ;J Maintenance Holes Securely Replaced: Name: ❑ Other (see attached) ❑ Yes ❑' No {] 1 3 z W ❑ Mound ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield Long Pull Fee: ❑ Baffles ❑ Baffles Address: ❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical issues ❑ Trenches ❑ Non-domestic waste ❑ Ponding/Surfacing Other Repairs: ❑ Effluent Filter/screen City/State/Zip: Cleaned? ❑ Yes ❑ No Comments: A Total Cost of Service: Payment Method: heck El Cash 1:1 Credit Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, Tank (check if present) designed operating depth designed operating depth cracked, unsecured, or appears to be structurally unsound El Septic/holding Tank #1 Gallons: ❑ Yes ❑yNo ❑ Yes O No ❑ Yes El -No ❑ Septic/holding Tank #2 Gallons: ❑ Yes O" No ❑ Yes ❑ No ❑ Yes E]'No ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 11 Pum Tank k Gallons:. ''- ElYes ElNo ❑ Yes D No ElYes _❑--No How Accessed: ❑ Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: ❑ Other (see attached) ❑ Yes ❑' No E]'Yes ❑ No ❑ Mound Did you 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 ❑ No Tank #2 ❑ Yes ❑ No Pump Tank ❑ Yes ❑ No System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity ❑ Mound ❑ 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: Disposal: ❑'end Application: ❑ Wastewater Treatment Plant )isposal Site: 34 Lime: Gallons 2 -,c --o Plowed: ❑ Yes ❑ No -ime: 'T y, Temperature: pH: f 2- 3 > 12 Ca' -ime: to L,;� Temperature: �, , pH: t 2 - � >12 ❑ s�-