HomeMy WebLinkAbout05/11/2022 Septic Maintenance InspectionEnde Septic Service, LLC
24910 Territorial Road • Rogers, MN 55374
Plione: 763-428-4489 t.e-mail: info(ti;cndeseptic.com
MPCA .License #: L2654
Maintenance Inspection Form
Maintainer name: ❑ Tristan Ef Brandon ❑ Scott
❑ Dvlan ❑ Keven
'Panic (Check if present)
Invoice
Name: .I /
Description:
Address:
Total Cost of Service:
City/State/Zip:
Payment Method: ❑ Check ❑ Cash ❑ Credit
'Panic (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
structurally sound
® Septic/holding Tank #1
❑ Yes ❑ No
❑ )"es ❑ No
❑ Yes ❑ No
Gallons:
❑ Non-domestic waste
❑ Ponding/surfacing
❑ Septic/holding Tank #2
❑ Yes ❑ No
❑ Yrs ❑ No
❑ Yes ❑ No
Gallons: :
Cleaned? ❑ Yes ❑ No
❑ Pretreatment Tank
❑ Yrs ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
O Pump Tank
❑ 1'e ❑ No
❑ Yrs ❑ No
❑ Yes ❑ No
Gallons:
Did you measure the accumulation of scum and sludge? ❑ Yes ❑ No
if the maintenance hole was used, were covers secured in place? ❑ Yes ❑ No
Diel you identify any operational issues or unsafe coalitions iehile assessing the sen+age tanks in this system, i.e.,
cracked tanks, missing baffles, broken corers, 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:
Is a mound cleaning recommended at this time: 0 Yes ❑ No Next Service: 0 1 yr ❑ 2 yr ❑ 3 yr