HomeMy WebLinkAbout06-29-2022 Septic Maintenance Inspection Jim Eicher Maintenance Inspection Form
i, MPCA Lic. # 654
'♦* Maintainer f1 Jim
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r� I I Duane
pi V� IES I I Nick
Septic Service, LLC • Phone: 763-497-2764
1205 LaBeaux Ave NE
St. Michael, MN 55376 • Email: duaneseptic@centurylink.net
DATE INVOICE
Pumping Fee: Name: _
Long Pull Fee: Address:
Other Repairs: City/State/Zip:
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Total Cost of Service: Payment Method: ❑ Check LI Cash ❑ Credit
•
Tank leaks below the Tank leaks above the Maintenance hole cover is damaged,
Tank(check if present) designed operating depth designed operating depth cracked,unsecured,or appears to be
structurally unsound
ü Septic/holding Tank#1 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No
Gallons:
❑ Septic/holding Tank#2
Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes LC No
❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes 0 No ❑ Yes ❑ No
Gallons:
❑ Pump Tank ❑ Yes 0-No ❑ Yes ❑" No 0 Yes ❑ No
Gallons:
How Accessed:❑Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
❑Other(see attached) ❑Yes ❑ No ❑ Yes ❑ 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 covers, etc.?If so, explain in comments below.
Tank#1 ❑ Yes E'No Tank#2 ❑ Yes 0 No Pump Tank ❑ Yes 0 No System
❑ Structural integrity ❑ Structural integrity ❑ Structural integrity D Mound
❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield
❑ Baffles El Baffles ❑ Baffles ❑ Pressure bed
LI Non-domestic waste 0 Non-domestic waste ❑ Electrical issues ❑ Trenches
LI Non-domestic waste ❑ Ponding/Surfacing
❑ Effluent Filter/screen ❑ Other:
Cleaned? 0 Yes 0 No
Comments:
Disposal: 0 Land Application: ❑Wastewater Treatment Plant
Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No
Time: Temperature: pH: >12 ❑
Time: Temperature: pH: >12 ❑
r,� Q. THANKS! , ��. ��
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