HomeMy WebLinkAbout07-11-2022 Septic Maintenance InspectionSeptic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE 7
Maintenance Inspection Form
Z�MA Lic. # 654
Maintainer
D Duane
D Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
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Pumping Fee:
Scum/Sludge Measured
Name:
Reason For P mping:
❑ Other (see attached)
❑ Yes 14 d
If r �es ❑ No
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„t.('� D Its
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Long Pull Fee: a-�
❑ Baffles
t
Address: 33('r. �Yi c �.
r l i x c.
Other Repairs:
❑ Non-domestic waste
City/State/Zip::
❑ Trenches
❑ Non-domestic waste
❑ Ponding/Surfacing
❑ Effluent Filter/screen
Total Cost of Servic �7
Payment Method: ❑ Check ❑ Cash
❑ Credit
Comments:
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
structural) unsound
eptic/holding k #1
Gallons: 05
❑ Yes No
❑ Yes 0-K-0—
❑ Yes
❑" o _
R"5eptic/hong nk #2
G
Gallons:/
❑ Yes C1'No
❑Yes 9_1z_9_1z_
❑Yes
f�-IVo
❑ Pretreatment Tank
Gallons:
❑ Yes ❑ No
❑ Yes ❑ NooEIYes
❑ No
ump Tan
❑Yes �L'i No
❑ Yes Q'No
El Yes
Gallons:
How Accessed. -Maintenance Hole
Scum/Sludge Measured
Maintenance Holes Securely Replaced:
Reason For P mping:
❑ Other (see attached)
❑ Yes 14 d
If r �es ❑ No
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Did you Identify any perational Issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cra�tanks, missing baffles, broken coversretc:7 If so, exolaln In comments below_.
Tank #1 ❑ Yes Wo
Tank #2 ❑ Yes E?Iqo
Pump Tank ❑ Yes o
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
eIVIound
❑ 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: Land Application: ❑ Wastewater Treatment Plant
Disposal Site: 'i
cam'
Lime: ✓ Gallons Z.p r_,
Plowed: ❑ Yes
❑ No
Time: t . i
Temperature: -I ,
pH: j? .
> 12•-E❑
Time: 1 t� ,-,
Temperature: -11
pH: 1
> 12 ❑
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