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HomeMy WebLinkAbout08-16-2022 Septic Maintenance InspectionDUANE� Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 n ATC ( — I (_ - Z ?- Maintenance Inspection Form MPCA Lic. # 654 Maintainer D Jim Duane ick • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net 1. INVOICE , , Pumping Fee:3 ��, Scum/Sludge Measured Maintenance Holes Securely Replaced: Name: r 6'r-. ❑ Yes C7 No Long Pull Fee: Mound 0 Risers leaking Addres ❑ Risers leaking ❑ Elevated dralnfield ❑ Baffles ❑ Baffles ❑ Baffles Zp }C4rNnPu ❑ Non-domestic waste Other Repairs: ❑ Trenches City/State/Zip: ❑ Non-domestic waste ❑ Ponding/Surfacing w- 4 ❑ Effluent Filter/screen ❑ Other: ¢- Cleaned? ❑ Yes ❑ No Total Cost of Service:�thc.ti(C Comments: Payment Method: --?53% [TCheck ❑ Cash ElCredit y yo , y �o 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 structurals unsound eptic/holding Tank #1 13 Yes LYf�_ ❑Yes R-151-0—❑Yes E"I�O' Gallon : C�.9Q ❑ Septic/holding Tank #2 ❑ Yes C No ❑ Yes RIG ❑ Yes ®'Iqo Gallons: ❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: Pump Tank El Yes �� 3 -N -o ❑ Yes U-90--"' YNo EI. Yes ®`tom Gallons: CR2� How Accessed: aintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: ❑ Other (see attached) ❑ Yes C7 No C3"1'es ❑ No Mound Did you Identify any operational issues or unsafe conditions while assessing the sewage tanks In this system, I.e., rrarkarl rankc_ micsinn hefFles. hrnken covers. etc.? If so. exolaln In comments bsJow. Tank #1 ❑ Yes o Tank #2 ❑ Yes o Pump Tank ❑ Yes No System ❑ Structural integrity ❑ Structural integrity ❑ Structural Integrity Mound 0 Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated dralnfield ❑ 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: B -i and Application: ❑ Wastewater Treatment Plant Disposal Site: Lime: Gallons Z ioO Plowed: ❑ Yes --M-No Time: 9e ,0 Temperature: (v � pH: Z , x > 12 Time: cjg(p Temperature: (r (,a pH: > 12 IT- N� _ VAL V�.' �