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Jim Eicher Maintenance Inspection Form <br />MPCA Lic. # 654 <br />i6t <br />Maintainer JimEh-0�ne <br />= Nick <br />Septic Service, LLC • Phone: 763-497-2764 <br />1205 LaBeaux Ave NE <br />St. Michael, MN 55376 •Email: duaneseptic@centurylink.net <br />1-7_ 17 iNvnicF <br />ufai r <br />Pumping Fee: <br />33 ez.5 <br />Pump Tank ❑ Yes ❑ o <br />Name: <br />❑ Structural integrity <br />Long P II Fee: <br />•, <br />EMound <br />Address: v <br />L� <br />Other Repai : <br />❑ Elevated dralnfield <br />❑ Baffles <br />City/State/Zip: <br />❑ Baffles <br />❑ Pressure bed <br />❑ Non-domestic waste <br />❑ Non-domestic waste <br />❑ Electrical Issues <br />❑ Trenches <br />Total Cost of Service: <br />❑ Non-domestic waste <br />❑ Ponding/Surfacing <br />P yment Method: ❑ Check ❑ Cash ❑ Credit <br />❑ Effluent Filter/screen <br />❑ Other: <br />Cleaned? ❑ Yes ❑ No <br />Comments: <br />61 <br />Maintenance hole cover is damaged, <br />Tank (check'If present) <br />Tank leaks below the <br />designed operating depth <br />Tank leaks above the <br />designed operating depth <br />cracked, unsecured, or appears to be <br />structural) unsound <br />C"eptic/holding Tank #1 <br />❑ Yes <br />' � <br />Cv1No <br />❑ Yes �xo <br />❑ Yes 6-4lo <br />Gallons: i i — a <br />n-geptic/holding Tank #2 <br />❑ Yes <br />[�—No <br />❑ Yes ENO <br />❑ Yes <br />Gallons: i v v <br />❑ Pretreatment Tank <br />❑ Yes <br />❑ No <br />❑ Yes ❑ No <br />J <br />❑ Yes ❑ No <br />Gallons: <br />CSI-P'ump Tank <br />El Yes ❑`No <br />o � d <br />❑Yes <br />❑ No <br />11 Yes ❑' No <br />Gallons: r <br />How Accessed: aintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reaso For Pumping: <br />r <br />❑ Other (see attached) i l es ❑ No C4N s ❑ No <br />Did you identlry any operational Issues or unsafe conditions while assessing the sewage tanks In this system, i.e., <br />,.f.. rr,, vnlnln In __-t< hP/nw. <br />Tank #1 ❑ Yes o <br />Tank #2 ❑ Yes <br />Pump Tank ❑ Yes ❑ o <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />EMound <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Elevated dralnfield <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />❑ Pressure bed <br />❑ Non-domestic waste <br />❑ Non-domestic waste <br />❑ Electrical Issues <br />❑ Trenches <br />❑ Non-domestic waste <br />❑ Ponding/Surfacing <br />❑ Effluent Filter/screen <br />❑ Other: <br />Cleaned? ❑ Yes ❑ No <br />Comments: <br />Disposal: ❑ Land Application: UWastewater Treatment dant Uv <br />Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No <br />Time: Temperature: pH: >12 ❑ <br />Time: Temperature: pH: > 12 ❑ <br />