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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 Maintenance Inspection Form <br />Phone: 763-4284489 • e-mail: <br />tMPPCA License #: L2654 M/ai�ntai ner rtame: ❑ Tristm4 Brandon El Scott <br />�tl Maintenance ❑ Emeraencv ❑ Other U/ �l (./ ❑ Dylan ❑ <br />Date: — <br />Invoice <br />Name: a �� <br />Description: <br />Address: SLgL9 AsAZ&& <br />Total Cost of Service: <br />City/State/Zip: <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />Tank (check if present) <br />Tank leaks below the <br />Tank leaks above the <br />Maintenance hole cover is <br />❑ Structural integrity <br />designed operating <br />designed operating <br />damaged, cracked, <br />❑ Risers leaking <br />depth <br />depth <br />unsecured, or appears to be <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />structurally sound <br />Jp Septic/holding Tank #1 <br />❑ Yes KNo <br />❑ Yes I No <br />❑ Yes No <br />Gallons: <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />A rSeptic/holding Tank #2 <br />❑ Yes 11 l No <br />❑ Yes ( No <br />❑ Yes Xl No <br />Gallons: S� <br />Cleaned? ❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />{6' ump Tank <br />❑ Yes ^No <br />❑ Yes ONo <br />❑ Yes 'No <br />Gallons: I Z. Q0 <br />Did you measure the accumulation of scum and sludge? <br />If the maintenance hole was used, were covers secured in place? <br />Yes ❑ No <br />Yes ❑ No <br />Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, ie., <br />cracked tanks-, missing baffles, broken covers, etc.? /f so, explain in comments below. <br />Tank #1 ❑ Yes kNo <br />Tank #2 ❑ Yes ANo <br />Pump Tank ❑ Yes o <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />Mound <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Risers leaking <br />Elevated drainfield <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 />Is a mound cleaning recommended at this time: ❑ Yes UIo Next Service: 0 1 yr ❑ 2 y43.43 yr <br />