HomeMy WebLinkAbout10-05-2021 Septic Maintenance InspectionEnde Septic Service, I.LC
24910 Territorial Road • Rogers, MN 55374
Phone: 763-428-4489 - e-mail:
MPCA License #: 1.2654
❑ Maintenance ❑ Emergency ❑ Other
Maintenance Inspection Form
Maintainer name: ❑ Tristan Brandon ❑ Scott
❑ Dylan ❑
Date: �'
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Invoice
Name:
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Description:
Address: 1
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Total Cost of Service:
City/State/Zip:
depth
unsecured, or appears to be
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 o
❑ Yes ❑
❑ Yes No
Gallons:
((
❑ Ponding/surfacing
❑ Septic/holding Tank #2
❑ Yes o
❑ Yes o
❑ Yes �No
Gallons:
Cleaned? ❑ Yes ❑ No
X
❑ Pretreatment 'Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
❑ Pump Tank
❑ Yes 'Io
❑ Yes No
Cl Yes No
Gallons:
I
Did you measure the accumulation of scum and sludge?
if the maintenance hole was used, were covers secured in place?
16 Yes ❑ No
qYes ❑ No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cracked tanks, missing baffles, broken covers, etc.? Ifso, explain in comments below.
Tank #1 ❑ Yes No
Tank 92 ❑ Yes No
Pump Tank ❑Yes o
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
❑ Mound
❑ Risers leaking
El 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: ElYes ❑ No Next Service: 111 yr 0 2 yr 0 3 yr