HomeMy WebLinkAbout08-05-22 Septic Maintenance InspectionJim Eicher
D
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
1'1ATC 4_. cry i ri
Maintenance Inspection Form
MPCA Lic. # 654
Maintainer Jim
D Duane
'Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
INVOICE
V v
Pumping Fee:2
4 J 's7o 'C -LD
Tank #2 ❑ Yes o
Name: (
V Gh
❑ Structural Integrity
❑ Structural integrity
Long Pull Fee:
l(DD.&-o
+ 147
❑ Risers leaking
Address:
p
&. . :ccJ
kw
Other Rep i s: yG
❑ Non-domestic waste
❑ Non-domestic waste
City/State/Zip:
❑ Non-domestic waste ❑ Ponding/Surfacing
❑ Effluent Filter/screen ❑ Other:
Cleaned? ❑ Yes ❑ No
Total Cost of Service:
k
Payment Method:
Check
❑ Cash ❑ Credit
400,
do
-4;� L] ( E>
b CV
Maintenance hole cover is damaged,
Tank (check if present)
Tank leaks below the
designed operating depth
Tank leaks above the
designed operating depth
cracked,
unsecured, or appears to be
structural) unsound
D— eptic/holding Tank #1
El Yes
C Io�
❑Yes
E7-Pdo
❑Yes Cn'l�o
Gallons: t S'0,�
0-Septic/holding Tank #2
❑ Yes
0''9-0—
❑Yes
❑Yes
Gallons:
❑ Pretreatment Tank
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes ❑ No
Gallons:
Pump Tank
❑Yes
Q No
❑Yes
[
❑Yes
Gallons: l pep
1
-low Accessed:[Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
El Other (see attached) ❑ Yes 2<0 ❑ Nc 4
Did you Identify any operational issues or unsafe conditions while assessing the sewage tanks In this system, I.e.,
- -f i ,..r«;.,., ti.rf — h—L— -c orr 7 if cn. exnlaln In comments below.
Tank #1 ❑ Yes Ef No
Tank #2 ❑ Yes o
Pump Tank ❑ Yes No System
❑ Structural Integrity
❑ Structural integrity
❑ Structural integrity ETMound
Q 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: ErOastewater Treatment Plant W"' '
)isposal Site: Lime:
Gallons ? —o -C>
Plowed: ❑ Yes
❑ No
Fime:
Temperature:
pH:
> 12 ❑
rime:
Temperature:
pH:
>12 0