HomeMy WebLinkAbout06-14-2023 Septic Maintenance Inspection Jim Eicher Maintenance Inspection Form
s^ MPCA Lic. # 654
�j,A Maintainer I I Jim
-...„ I 1 D u ane
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DUANIS �.
* ;-Nick
Septic Service, LLC • Phone: 763-497-2764
1205 LaBeaux Ave NE
St. Michael, MN 55376 • Email: duaneseptic@centurylink.net
: INVOICE
DATE �. '1 il () �-
Pumping Fee: Name: ,
Per 2...,3 ti.. . fi 'b.;.,.' vAl,.:a{""5�•:•'le; I. .-i, 3
Long Pull Fee:
} Address:
7g f
Other Repairs: City/State/Zip:
Total Cost of Service .. .. Payment Method: CI- heck ❑ Cash ❑ Credit
C
Maintenance hole cover is damaged,
- Tank leaks below the Tank leaks above the cracked,unsecured,or appears to be
Tank(check if present)'V designed operating depth designed operating depth
structurally unsound
C Septiclhalding Tank#1 ❑ Yes <� No ❑ Yes Et Na ❑ Yes ❑ No
Gallons. .. x -, ? _
❑.Septic/holding Tank#2 `_
Gallons: ,� ❑ Yes [ `No ❑ Yes 0,-NO 0 Yes C tlo
❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No
Gallons:
❑,Pump Tank "
Gallons: , c "
❑ Yes ❑ 10 ❑ Yes [ iVo El Yes ❑ .{
How Accessed:EMaintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
❑Other(see attached) 0 Yes ❑ No L Yes ❑ No /1%--1 em:,;;, _.
I
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.?If so, explain in comments below.
Tank#1 ❑ Yes 0 No Tank#2 ❑ Yes 2t to Pump Tank ❑ Yes 2116 System
❑ Structural integrity ❑ Structural integrity 0 Structural integrity Efr
❑ Risers leaking 0 Risers leaking 0 Risers leaking 0 Elevated drainfield
❑ Baffles 0 Baffles ❑ Baffles ❑ Pressure bed
❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical issues ❑Trenches
0 Non-domestic waste 0 Ponding/Surfacing
❑ Effluent Filter/screen ❑ Other:
Cleaned? ❑Yes 0 No
Comments:
Disposal: ❑ Land Application: ❑Wastewater Treatment Plant
Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No
Time: Temperature: pH: >12 D
Time: Temperature: pH: >12 ❑
�, A y % yTHANKSi * J
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