HomeMy WebLinkAbout06-21-22 Septic Pumping InspectionEnde Septic Service, LLC
24910 Territorial Road • Rogers, MN 55374 Maintenance Inspection Form
Phone: 763-4284489 • e-mail:
MPCA License #: L2654 Maintainer name: ❑ Tristan Brandon ❑ Scott
Maintenance ❑ Emer ency ❑ Other
LJDvlan ❑
Date:
Invoice
Name: h
Description:o�' d S , ,-
Address: t'/ S
otal Cost of Service: r/ $ 3 O • a
City/State/Zip:
Payment M thod: heck ❑ Cash ❑' Credit
d�
Tank (check if present)
Tank leaks below the
Tank leaks above the
Maintenance hole cover Is
❑ Structural integrity
designed operating
designed operating
damaged, cracked,
❑ Risers leaking
depth
depth
unsecured, or appears to be
❑ Baffles
❑ Baffles
❑ Baines
structurally sound
Al Septic/holding Tank #1, .
❑ Yes (Ie'No
❑ Yes No
❑ Yes No
Gallons: 2205dI
❑ Non-domestic waste
❑ Ponding/surfacing
Septic/holding Tank #2
❑ Yes "o
11Yes No
11Yes No
Gallons:
Cleaned? ❑ Yes ❑ No
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
Pump Tank
❑ Yes No
11 Yes No
El Yes ki No
Gallons:
Did you measure the accumulation of scum and sludge?
If the maintenance hole was used, were covers secured in place?
;Yes 11 No
J�`4`,es ❑ No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cracked tanks, missing baffles, broken toners, etc.? If so, eeplain in comments below.
Tank #1 El Yes No
Tank #2 ❑YeskNo
Pump Tank ❑ YeACNo
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
46mound
❑ Risers leaking
❑ Risers leaking
❑ Risers leaking
❑ Elevated drainfield
❑ Baffles
❑ Baffles
❑ Baines
❑ Pressure bed
❑ Non-domestic waste
❑ Non-domestic waste
❑ Electrical issues
❑ Trenches
❑ Non-domestic waste
❑ Ponding/surfacing
❑ Effluent Filter/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
Comments: IIGS-- \\ 5Q/'l/j e /�e'C �t/1z m/J
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Is a mound cleaning recommended at this time: ❑ Yes 4tNo Next Service: ❑ 1 yr 0 2 yrV yr