HomeMy WebLinkAbout06-10-2023 Septic Maintenance Inspection Jim Eicher Maintenance Inspection Form
4MPCA Lic. #654
•
� � Maintainer i I Jim
tii 1 Duane
► i * ick
Septic Service, LLC • Phone: 763-497-2764
1205 LaBeaux Ave NE
St. Michael, MN 55376 • Email: duaneseptic@centurylink.net
DATE (4a- f a-Z. INVOICE
Pumping Fee: Name:
3 7 S`.- L z4'5\s'''N L.me....
Long Pull Fee: Address: 094 ' ir a
ot ,
Other Repair City/State/Zip:
Total Cost of Se --------
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Payment Method: ❑ Check ❑ Gash ❑ Credit
4 9‘,3-,0-40' }
Tank(check ifpresent) Tank leaks below the Tank leaks above the
Maintenance hole cover is damaged,
designed operating depth designed operating depth cracked,unsecured,or appears to be
structurally unsound
eptic/holding Tank#1 —�
Gallons: El Yes C31"'IVo ❑ Yes 1"<O El Yes 1L�No
,�' G- v
Er eptic/holding Tank#2 /" �`
Gallons: c 9_ CI Yes -Er-NO- ❑ Yes C'"No ❑ Yes C9'No
❑ Pretreatment Tank ❑ Yes 0 No ❑ Yes 0 No ❑ Yes ❑ No
Gallons:lo�
l�'Pump Tank /�
Gallons: A ❑ Yes No ❑ Yes Q No ❑ Yes [�•'�
v 0'D
How Accessed:1 l Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
❑Other(see attached) ❑Yes 13i Er es ❑ No l,,vtex,.tA,.L-
Old 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 0 Yes10 Tank#2 ❑ Yes 10 Pump Tank ❑ Yes o - System
❑ Structural integrity ❑ Structural integrity _ ❑ Structural integrity 2i ound
❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield
❑ Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed
❑ Non-domestic waste 0 Non-domestic waste El Electrical issues ❑ Trenches
❑ Non-domestic waste ❑ Ponding/Surfacing
❑ Effluent Filter/screen 0 Other:
Cleaned? 0 Yes 0 No
Comments: i 11 41 C-7 E)ticoer,O
Disposal: land Application: ❑Wastewater Treatment Plant
Disposal Site: 'VA Lime: / Gallons j0-0 Plowed: ❑ Yes 12-1Co
Time: i t,p Temperature: L V. V pH: E-a_Lf >12
Time: 1 t14P Temperature: 1 5-; 3 pH: 1 z y >12 .
,,, ..., 0111;-% / .0$m k4°1—* C .fi�THANKS! 41 ,
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