HomeMy WebLinkAbout07-06-2022 Septic Maintenance InspectionEnde Septic Service, LLC
24910 Territorial Road • Rogers, MN 55374
Phone: 763-428-4489 • e-mail:
Maintenance Inspection Form
MPCA License #: 1,2654 Maintainer name: ❑ TristanABrandon ❑ Scott
Maintenance ❑ Emer enc ❑ Other ❑ Dylan ❑
Date: 247—?_z_
Invoice
Name:
e S,
Description: �S 'C"'
Address:/
Total Cost of Servi o -
City/State/Zip: /'p 1-D
Payment Method: ❑ Check ❑ Cash ❑ Credit
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
❑ Baffles
structurally sound
Septic/holding Tank #1
❑ Yes G�No
❑ Yes djrNo
❑ Yes INo
Gallons: IZip IS
❑ Non-domestic waste
❑ Ponding/surfacing
Septic/holding Tank #2
❑ Yes KNo
El Yes AqNo
❑ Yes -1 No
allons:
Cleaned? []Yes ❑ No
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
J�Pump Tank
❑ Yes KNo
El Yes 4No
❑ Yes ekNo
Gallons:
Did you measure the accumulation of scum and sludge? Yes ❑ No
If the maintenance hole was used, were covers secured in place? ONYes ❑ No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, Le.,
cracked tanks, musing baffles, broken covers, etc.? /fso, eViain in comments below.
Tank #1 ❑ Yes VNo
Tank #2 ❑ Yes o
Pump Tank ❑ Yes No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
*Mound
❑ 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:
Is a mound cleaning recommended at this time: ❑ Yes kNo Next Service: 0 1 yr 0 2 y+ yr