HomeMy WebLinkAbout11/22/2021 Septic Maintenance InspectionEnde Septic Service, LLC
24910 Territorial Road • Rogers, MN 55374
Phone: 763-428-4489 • e-mail: info(Wendeseptic.com
MPCA License #: L2654
Maintenance Inspection Form
Maintainer name: ❑ Tristan JW Brandon ❑ Scott
❑ Dylan ❑ Keven
Date: I I- 01 a. a III
Invoice
Name: -DtaV e, �.i� � l l S
Description:
Address: I 10 cl W 4:7a Y7n
Total Cost of Service:
City/State/Zip: Q COn O Il N
Payment Method: ❑ Check ❑ Cash ❑ Credit
Tank (check if present)
Tank leaks below the
Tank leaks above the
Maintenance hole cover is
❑ Structural integrity
designed operating
designed operating
damaged, cracked,
❑ Risers leaking
depth
depth
unsecured, or appears to be
❑ Baffles
❑ Baffles
❑ Baffles
structurally sound
Septic/holding Tank #1
❑ Yes No
❑ Yes No
❑ Yes PNo
Gallons: / 0 0'0
❑ Non-domestic waste
❑ Ponding/surfacing
Septic/holding Tank #2
❑ Yes No
❑ Yes 1�PNo
❑ Yes No
Gallons: / 0-010
Cleaned? ❑ Yes ❑ No
❑ Prtri eatment Tank
s
❑Yes o
❑ Yes ❑ No
Gallons.
§iLPump Tank
❑ Yes 1C3No
❑ Yes ;P1110
❑ Yes I'lo
Gallons: 50 0
Did you measure the accumulation of scum and sludge? ❑ Yes )I No
If the maintenance hole was used, were covers secured in place? JO Yes ❑ No
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.? /f so, explain in comments below.
Tank #1 ❑ Yes `C No
Tank #2 ❑ Yes ]sd No
Pump Tank ❑ Yes 0 No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
Rmound
❑ 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:
1
Is a mound cleaning recommended at this time: ❑ Yes R No Next Service: 0 1 yr 0 2 yr �O yr