HomeMy WebLinkAbout06-14-2023 Septic Maintenance Inspection Jim Eicher Maintenance Inspection Form
MP Lic. # 654
,.�+A,�T`, Maintainer Jim
`�► I 1 Duane
DVANkS I J Nick
Septic Service, LLC
1205 LaBeaux Ave NE • Phone: 763-497-2764
St. Michael, MN 55376 • Email: duaneseptic@centurylink.net
DATE (0—t q"23
INVOICE
Pumping Fee: ._, Name: Aacvyvl c g r.ct
Long Pull Fee: z„..? fAddress: 1-0,,,00_,,,,,„„ti
Other Repairs:
" 70 Ct Ovey, ..1..0.t-5 City/State/Zip:
4 /0a zo `r C>��
Total Cost of Servic • Payment Method: ❑ Check ❑Cash ❑ Credit
4 67
Tank leaks below the Tank leaks above the Maintenance hole cover is damaged,
Tank(check if present) cracked,unsecured,or appears to be
designed operating depth designed operating depth
structurally unsound
Septic/holding Tank#1
Gallons: �' 0 Yes Flo` ❑ Yes C1a 0 Yes CT Na
fptic/holdin Tank#2
Gallons: /;2 ❑ Yes ❑ Yes C "No El Yes C�No
❑ Pretreatment Tank
Gallons: ❑ Yes ❑ No ❑ Yes 0 No CIYes 0 No
imp Tank ��
Galians:II � ❑ Yes Q Na ❑ Yes LIT‹.----
❑ Yes Fr No
l
How Accessed:®Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For P m in :
0 Other(see attached) 0 Yes Crgo ❑les 0 No 4.
Did you Identify a y operational Issues or unsafe conditions while assessing the sewage tanks In this system, i.e,,
eked tanks,missing baffles,broken co s,etc.?If so, explain In comments Gel .w.
Tank#1 ❑ Yes o Tank#2 ❑ Yes o Pump Tank ❑ Yesa System
❑ Structural integrity ❑ Structural integrity ❑ Structural integrity 'foound
❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfleld
❑ Baffles 0 Baffles ❑ Baffles 0 Pressure bed
❑ Non-domestic waste 0 Non-domestic waste 0 Electrical Issues ❑ Trenches
El Non-domestic waste 0 Ponding/Surfacing
❑ Effluent Filter/screen ❑ Other:
Cleaned? 0 Yes ❑ No
Comments:
Disposal: — ❑ Land Application: 0 Wastewater Treatment Plant
Disposal Site: Lime: ----_ Gallons - Plowed: ❑ Yes_.a...❑ No
�..C7�,�iiwl
Time: I t._, e t.3 Temperature:p pH; i ,,° a j 2--❑
Time: t ; :z., Temperature: pH: , >12F Ci
• .► c . THANKS! ,• ,•
'.... cam , . - $ .. cam' •igjo.h........S,