HomeMy WebLinkAbout05-24-2022 Septic Maintenance InspectionDVE*
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael,MN 55376
,7
DATE -Zq'Z,1i
Maintenance Inspection Form
ZMJM
CA Lic. # 654
Maintainer
Duane
D Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
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Pumping Fee:
Scum/Sludge Measured
Name:
Reason For Pumping:
❑ Other (see attached)
D Yes 0.6.
q ❑ No
❑ Risers leaking C3 'Risers leaking
❑ Elevated dralnfield
❑ Baffles
Long Pull Fee:
❑ Pressure bed
Address: 7:7a
2-(
❑ Trenches
> 12--B
❑ (Non-domestic waste
❑ Ponding/Surfacing
V4-,( VLA
C3 Effluent Filter/screen
Other Repairs:
City/State/Zip:
Comments:
C) �D f1t 7J
Total Cost of Service:
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poo
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
Sholding Tank #1
Gallons: %Lj'&
G����ons:
❑ Yes �o
^
❑ Yes >:7 -No
❑ Yes
-C�1 No
❑`'Septic/hgldi% Tank #2
❑ Yes 11
El Yes �
El Yes
❑ No
Gallons: [�ij
0
❑ Pretreatment Tank
Gallons:
E] Yes El No
❑ Yes CD No
El Yes
❑ No
EI Pump Tank
EIYes o
❑ Yes
Yes
Gallons: 1'2ijD
P"N
P_<❑
PIA
How Accessed: aintenance Hole
Scum/Sludge Measured
Maintenance Holes Securely Replaced:
Reason For Pumping:
❑ Other (see attached)
D Yes 0.6.
q ❑ No
❑ Risers leaking C3 'Risers leaking
Dld you idenfy a y operational Issues or unsafe condit' s while assessing the sewage tanks in this system, I.e.,
ti
z acked tanks, missing baffles, broke overs, etc.? If so, explain In commen�elow.
Tank #1 D Yes A,No
Tank #2 ❑ Yes 0 No Pump Tank ❑ Yes No
System
❑ Structural integrity
❑ Structural Integrity ❑!Structural integrity
Mound
❑ Risers leaking
❑ Risers leaking C3 'Risers leaking
❑ Elevated dralnfield
❑ Baffles
❑ Baffles ❑ (Baffles
❑ Pressure bed
❑ Non-domestic waste
❑ Non-domestic waste ❑ Electrical Issues
❑ Trenches
> 12--B
❑ (Non-domestic waste
❑ Ponding/Surfacing
C3 Effluent Filter/screen
❑ Other:
Craned? ❑ Yes ❑ No
Comments:
Disposal: --❑ Land Application: ❑ Wastewater Treatment Plant
Disposal Site:
Lime: Gallons
oft 0
Plowed: El Yes
-8-96
Time: F <I
Temperature:
pH:
> 1.2--CJ-
Time: 5t
Temperature:
,4
pH:
> 12--B