HomeMy WebLinkAbout06-14-22 Septic Maintenance ReportSeptic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MNN 55376
DATE G N'ZZ—
Maintenance Inspection Form
rill
A Lic. # 654
Maintainer
Duane
D Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
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Pumping Fee: S70
Scum/Sludge Measured
Name: i a
I 14
Long Pull Fee:
❑ Structural integrity
Address:
2�Ab
i 0 �.
Other Repairs:
El Yes [�No
City/State/Zip:
�n•.�^�i 1
❑ Baffles
❑ Baffles
❑ Baffles
❑ Pressure bed
�—
Total Cost of Service., _
❑ Electrical issues
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
Septic/holdin nk #1
Gallons: i Z.)
❑ Yes
2_1q_0
❑ Yes No
❑ Yes 1_=k<0
eptic/holding TAnk #2
Gallons: j , L 5,-L-)
❑ Yes
C'No
❑ Yes51 No
❑ Yes E^--O--
❑ Pretreatment Tank
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
� Pump TankI]Yes
13Yes
Gallons: j 25D
No
E;.I o
EDYes No
How Accessed. Maintenance Hole
Scum/Sludge Measured
Maintenance Holes Securely Replaced:
Reason For Pumpiifig:
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
ound
EJ Other (see attached)
El Yes [�No
B'Yes El No
�n•.�^�i 1
Did you identify a y operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
_xfacked tanks, missing baffles, broken_Peve-rs, etc.? if so, explain in comments—te �ow.
Tank #1 ❑ Yes No
Tank #2 ❑ Yes KrNo
Pump Tank ❑ Yes No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
ound
❑ 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:
Disposal1. un I _a.dJ „Appl1:tca1u:o. �1AA/c�ts_itc_.w..a♦Le.
11 CaolICIn Flatn n,�}.ripyP.N
Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No
Fime: Temperature: pH: > 12 ❑
Fime: Temperature: pH: > 12 ❑