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HomeMy WebLinkAbout05/10/2022 Septic Inspection FormSeptic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 nATF = /f1-- ? Z Maintenance Inspection Form MPCA Lic. # 654 Maintainer O Jim Duane CNick • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net - Pumping Fee: � 35.E � Na e: Pump Tank ❑ Yes Tmo System IIY V VI</G ❑ Structural integrity ❑ Structural integrity a b, Vic® ❑ Risers leaking ❑ Risers leaking Long Pull Fee: ❑ Baffles Address: ❑ Baffles ❑ Pressure bed ❑ Non-domestic waste o.� ❑ Electrical issues 32 -o -s- 4 tt p_- Other Repairs: City/State/Zip: Effluent FlltSrlgereen ❑ Other: Cleaned? ZYes ❑ No G`d thE} Comments: Ct�s-rn �. t I-ev e✓Ar �j , �(. lam; II S ra-� e_ . �� �S 5.� (;,/ 1-v�t 4-- :1 4- t ti..'T'+o --�� �l. �5. 1 7 0A (/ii}dt� p t C5 �,L.X 4-v et h ( JJd J— /�h2P At-LLA.Q 114_ h cle J Total Cost of Service:c�v,� Payment Method: Check ❑ Cash ❑ Credit Vo 3CP 3 go Tank (check If present) Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, designed operating depth designed operating depth cracked, unsecured, or appears to be structural) unsound �c/holding Tank #1 Gallons: 1 Z Z;—v ❑ Yes ❑ Yes lti o ❑ Yes B-tVo' Septic/holding Tank #2 Gallons: I Z.5 -D, ❑ Yes Cr No ❑ Yes aN�o ❑ Yes B'ITo ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Tank Gallons: Gallons: t Z� ❑ Yes LI _ o ❑ Yes Cil No ❑ Yes �'No -low Accessed: aintenance Hole Scum/Sludge MeasuredMaintenance Holes Securely Replaced: Reason For Pumping: ❑ Other (see attached) CI Yes 041101,&-rees ❑ No 04 Did you Identify any operational Issues or unsafe conditions while assessing the sewage tanks In this system, i.e., cracked tanks. missina baffles, broken covets. etr.7 rfsn. exnlaln In rnmmanhc halnul Tank #1 ❑ Yes DW6 Tank #2 ❑ Yes TGo Pump Tank ❑ Yes Tmo System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity ound ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield ❑ Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed ❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical issues ❑ Trenches ❑ tJ domestic waste ❑ Ponding/Surfacing Effluent FlltSrlgereen ❑ Other: Cleaned? ZYes ❑ No Comments: Ct�s-rn �. t I-ev e✓Ar �j , �(. lam; II S ra-� e_ . �� �S 5.� (;,/ 1-v�t 4-- :1 4- t ti..'T'+o --�� �l. �5. 1 7 0A (/ii}dt� p t C5 �,L.X 4-v et h ( JJd J— /�h2P At-LLA.Q 114_ h cle J Disposal: ❑ Land Application: 8'VVastewater Treatment Plant Wit ��, N 0 Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No rime: Temperature: pH: >12 ❑ rime: Temperature: pH: > 12 ❑