Loading...
HomeMy WebLinkAbout05-03-2022 Septic Maintenance FormSeptic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 nAT1=��3-Z? Maintenance Inspection Form MP,CA Lic. # 654 1.11 Maintainer eJim O Duane Nick • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVnICF Pumping Fee: Scum/Sludge Measured MaintenanceHoles Securely Replaced: Name: Le L--- ElYes ❑'IVo❑s 4�� .Se //,, -f2 ❑ Risers leaking n h 0fln k 1 r- ❑ Elevated drainfield Long Pull Fee: � ❑ Baffles ❑ Baffles 1 Address: —70 0 `C\ Cr V � is l /5"q , 11 Other Repairs: +� ' l,e k tL c�� i ❑ Trenches City/State/Zip: ❑ Non-domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Total Cost of Service Comments: Payment Method: ❑ Check ❑ Cash ❑ Credit Tank (check if present) Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, cracked, unsecured, or appears to be designed operating depth designed operating depth structural) unsound Septic/holding Tank #1 V ❑ Yes Z No ❑ Yes No ❑ Yes L-tq6­_ Gallons: i 7_ eptic/holdin Tank #2 ❑ Yes 0 No El Yes Ca'No El Yes ❑'No Gallons: !'ZS ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No "Pump Tan � ❑ ❑ �IVo LI Yes 0 No G Gallons: 1�7 ❑ Yes Yes How Accessed: Maintenance Hole Scum/Sludge Measured MaintenanceHoles Securely Replaced: Reason Fpr Pumping: ElOther (see attached) ElYes ❑'IVo❑s 4�� .Se //,, -f2 J OId you IdenClfy any operational Issues or unsafe conditions while assessing the sewage tanks In this system, i.e., cracked tanks. misslna baffles, broken couefs, etc.? If so, explain in comments below. Tank #1 ❑ Yes ZPWo Tank #2 ❑ Yes o Pump Tank ❑ Yes o 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 O No Comments: Disposal: . O Land Application: ❑ Wastewater Treatment Plant Disposal Site: 3 5 Lime: Gallons z, Plowed: ❑ Yes ,.-E]-,No Time: c.3 Temperature: pH: ;. _:; > 12--8-- Time: f:} Temperature: c'z ' pH: > 1 2--f�-' P. .,.�-'�-•. ,�`'�'`� �-".sem..-�-.-,,� ,�,-,�.,.,, ,�'.,�- �"s�.>