HomeMy WebLinkAbout05/17/2022 Septic Maintenance InspectionJim Eicher Maintenance Inspection Form
MPCA Lic. # 654
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Maintainer JimEh-0�ne
= Nick
Septic Service, LLC • Phone: 763-497-2764
1205 LaBeaux Ave NE
St. Michael, MN 55376 •Email: duaneseptic@centurylink.net
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Pumping Fee:
33 ez.5
Pump Tank ❑ Yes ❑ o
Name:
❑ Structural integrity
Long P II Fee:
•,
EMound
Address: v
L�
Other Repai :
❑ Elevated dralnfield
❑ Baffles
City/State/Zip:
❑ Baffles
❑ Pressure bed
❑ Non-domestic waste
❑ Non-domestic waste
❑ Electrical Issues
❑ Trenches
Total Cost of Service:
❑ Non-domestic waste
❑ Ponding/Surfacing
P yment Method: ❑ Check ❑ Cash ❑ Credit
❑ Effluent Filter/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
Comments:
61
Maintenance hole cover is damaged,
Tank (check'If present)
Tank leaks below the
designed operating depth
Tank leaks above the
designed operating depth
cracked, unsecured, or appears to be
structural) unsound
C"eptic/holding Tank #1
❑ Yes
' �
Cv1No
❑ Yes �xo
❑ Yes 6-4lo
Gallons: i i — a
n-geptic/holding Tank #2
❑ Yes
[�—No
❑ Yes ENO
❑ Yes
Gallons: i v v
❑ Pretreatment Tank
❑ Yes
❑ No
❑ Yes ❑ No
J
❑ Yes ❑ No
Gallons:
CSI-P'ump Tank
El Yes ❑`No
o � d
❑Yes
❑ No
11 Yes ❑' No
Gallons: r
How Accessed: aintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reaso For Pumping:
r
❑ Other (see attached) i l es ❑ No C4N s ❑ No
Did you identlry any operational Issues or unsafe conditions while assessing the sewage tanks In this system, i.e.,
,.f.. rr,, vnlnln In __-t< hP/nw.
Tank #1 ❑ Yes o
Tank #2 ❑ Yes
Pump Tank ❑ Yes ❑ o
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
EMound
❑ Risers leaking
❑ Risers leaking
❑ Risers leaking
❑ Elevated dralnfield
❑ 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:
Disposal: ❑ Land Application: UWastewater Treatment dant Uv
Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No
Time: Temperature: pH: >12 ❑
Time: Temperature: pH: > 12 ❑