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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-428-4489 • e-mail: <br />Maintenance Inspection Form <br />MPCA License #: 1,2654 Maintainer name: ❑ TristanABrandon ❑ Scott <br />Maintenance ❑ Emer enc ❑ Other ❑ Dylan ❑ <br />Date: 247—?_z_ <br />Invoice <br />Name: <br />e S, <br />Description: �S 'C"' <br />Address:/ <br />Total Cost of Servi o - <br />City/State/Zip: /'p 1-D <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 />Septic/holding Tank #1 <br />❑ Yes G�No <br />❑ Yes djrNo <br />❑ Yes INo <br />Gallons: IZip IS <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />Septic/holding Tank #2 <br />❑ Yes KNo <br />El Yes AqNo <br />❑ Yes -1 No <br />allons: <br />Cleaned? []Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />J�Pump Tank <br />❑ Yes KNo <br />El Yes 4No <br />❑ Yes ekNo <br />Gallons: <br />Did you measure the accumulation of scum and sludge? Yes ❑ No <br />If the maintenance hole was used, were covers secured in place? ONYes ❑ No <br />Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, Le., <br />cracked tanks, musing baffles, broken covers, etc.? /fso, eViain in comments below. <br />Tank #1 ❑ Yes VNo <br />Tank #2 ❑ Yes o <br />Pump Tank ❑ Yes No <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 kNo Next Service: 0 1 yr 0 2 y+ yr <br />