Loading...
HomeMy WebLinkAbout08-23-2022 Septic Maintenance InspectionSeptic Service, LL 1205 LaBeaux Ave N St. Michael, MN 5531 DATE I'Z3-2'L aintenance Inspection Form n MPCA Lic. # 654 !::5�d Maintainer[] Jim Duane ick : 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Pumping Fee: 33© t¢ Scum/Sludge Measured Name: •� � �V Reason For Pumping: !1 ther (see attached) C1Yes 0- o-_ ❑ Yes ❑ Ni 'kms-+ p.GCck.s R ❑ Risers leaking ❑ Risers leaking Long Pull Fee: ❑ Baffles ❑ Baffles Address: 01_P ure bed ❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical Issues Iff Trenches 13 3 S ❑ Non-domestic waste Other Repairs: City/State/Zip: ❑ Other: Cleaned? ❑ Yes ❑ No Comments: Total Cost of Service: �—t t N L, Payment Method: heck ❑ Cash ❑ Credit 33�.. /01A lD X330 Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, Tank (check if present) designed operating depth designed operating depth cracked, unsecured, or appears to be structural) unsound eptic/holding Tank #1 ❑ Yes ❑-`o ❑ Yes El"No ❑ Yes ❑ No Gallons: f," v Septic/holding Tank #2 El Yes No C1 Yes J2' No ❑Yes ❑ No Gallons: ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Pump Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No How Accessed: ❑ Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: !1 ther (see attached) C1Yes 0- o-_ ❑ Yes ❑ Ni 'kms-+ /vo t'tiu 'WIt Did you Identify any operational Issues or unsafe conditions while assessing the sewage tanks In this system, I.e., cracked tanks, misslnq baffles, broken c2yers, etc.? Ifso, explain In comments below. Tank #1 ❑ Yes o Tank #2 ❑ Yes o Pump Tank ❑ Yes ❑ No System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity ❑ Mound O Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated dralnfield ❑ Baffles ❑ Baffles ❑ Baffles 01_P ure bed ❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical Issues Iff Trenches ❑ Non-domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑ Yes ❑ No Comments: Disposal: 0-Gand Application: ❑ Wastewater Treatment Plant Disposal Site: Lime: Gallons (3'----'> Plowed: ❑ Yes -f5- No Time: 3zi Temperature: o pH: I Z> f > 12 Time: Temperature: -70 pH: I Z_ j > 12