HomeMy WebLinkAbout07-11-2022 Septic Maintenance InspectionSeptic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE 1 JII-'Z7/
Maintenance Inspection Form
MPJLA Lic. # 654
Maintainer ��(JJiim
Duane
Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
Pumping Fee:
Scum/Sludge Measured
Oy ,
l
�u�
11 Other (see attached)
Name: ! 1 C
hC l
9 s El No
�G
Long Pull Fee: 46 JL-
Sd
❑ Risers leaking
❑ Elevated drainfield
❑ Baffles
Address:
❑ Baffles
❑ Pressure bed
❑ Non-domestic waste
❑ Non-domestic waste
❑ Electrical issues
❑ Trenches
❑ Non-domestic waste
❑ Ponding/Surfacing
Other Repairs:
❑ Effluent Filter/screen
City/State/Zip:
Cleaned? ❑ Yes ❑ No
Comments:
Total Cost of Servi
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
structurally
unsound
antic/ho g�Tank #1
❑Yes
No
Gallons:
❑Yes Com`
❑Yes
9-110--)
Septic/holdwin�g nk #2
Gallons: l 24 v
❑ Yes
0 No
❑ Yes
❑ Yes
❑ Pretreatment Tank
J
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
RTIP'ump Tank
Gallons: 2 Jai
❑ Yes
-fl No
❑ Yes C I No
❑ Yes
4�,'�o
How Accessed -n Maintenance Hole
Scum/Sludge Measured
Maintenannce—Holes Securely Replaced:
Reason For P ping:
11 Other (see attached)
❑Yes 2'No
9 s El No
�G
Did you Identify an peratlonel issues or unsafe conditions while assessing the sewage tanks in this system,T_e_,,
eked tanks, missina baffles. broken covers. etr.7 rf cn. ernlaln In rnmmontc holnw
Tank #1 ❑ Yes o
Tank #2 ❑ Yes No
Pump Tank ❑ Yes o
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:
Disposal: _-Q-Land Application: ❑ Wastewater Treatment Plant
Disposal Site: q
Lime: j Gallons 0 o"
Plowed: ❑ Yes
❑ No
Time: C)o
Temperature: b Z,
pH: 12 ,'
> 12 ,CO
Time: �; -. �• :;
Temperature: :.
pH: ;.
> 12_.:0