HomeMy WebLinkAbout07/25/2022 Septic Maintenance InspectionJim Eicher
kkD
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
Maintenance Inspection Form
MPCA Lic. # 654
Maintainer Jim
D Duane
lick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
INVOICE
V/11 G / - — - — -
Pumping Fee:
Tank #2 ❑ Yes o Pump Tank ❑ Yes ❑ No
Name:
❑ Structural Integrity
❑ Stru refihtegrity ❑ Structural integrity
3 75 -
0 Risers leaking
&. 13✓v 14.
❑ Pressure bed
❑ Baffles
❑ Non-domestic waste
Long Pull Fee:
Trenches
Addre�:(0'YO .
" 'I r -
❑ Ponding/Surfacing
�ther:
❑ Effluent Fllter/screen
✓&
-
Cleaned? ❑ Yes ❑ No
Other Repairs:
Comments:
Ir z ! SY S�e V,
City/State/Zip:
Total Cost of Service:
iC
Payment Method: ❑ Check ❑ Cash
❑ Credit
Maintenance hole cover Is damaged,
Tank (check If present)
Tank leaks below the
Tank leaks above the
cracked, unsecured,
or appears to be
designed operating depth
designed operating depth
structurally
unsound
❑TSept`c/holding Tank #1
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
Gallons: t L,�_Z
❑optic/holding Tank #2
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
Gallons: t Zoo
❑ Pretreatment Tank
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
Gallons:
O-Ffiump Tank
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
Gallons: t Z�—Q
How Acce ed: ❑Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reams For Pumping:
❑ Other tached) ❑Yes ❑ No ❑Yes ❑ / ,tr
Did you identify any opera l_' l Issues or unsafe conditions whlle a�S the sewage tanks in this system,
._ .- _nir 7 iF_ ovnlaln In rnmments below.
Tank #1 ❑ Yes ❑ No
Tank #2 ❑ Yes o Pump Tank ❑ Yes ❑ No
System
❑ Structural Integrity
❑ Stru refihtegrity ❑ Structural integrity
❑ Mound
❑ Elevated drainfleld
0 Risers leaking
isers leaking rs leaking
-Baffles ❑ Baffles�Iss
❑ Pressure bed
❑ Baffles
❑ Non-domestic waste
0
❑Non domestic waste ❑Electrica❑
Trenches
pH: 1 Z . (
❑ Non-domestic wase
❑ Ponding/Surfacing
�ther:
❑ Effluent Fllter/screen
Cleaned? ❑ Yes ❑ No
Comments:
Ir z ! SY S�e V,
nicnnsal- aCand Aoolicatlon: ❑ Wastewater Treatment Plant
)isposal Site: Ll I Lime:
Gallons 2 Zs�
Plowed: ❑ Yes
❑ No
Fime: 1010
Temperature: p
pH: 1 Z,1
> 12
F9'
time: 1 0 yu
Temperature: "? 1
pH: 1 Z . (
> 12
Cr