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HomeMy WebLinkAbout06-19-2023 Septic Maintenance Inspection Jim Eicher Maintenance Inspection Form 4MPCA Lic. #654 J,�ATIj Maintainer I I Jim t� 0 I 1 Duane DVANES 4.0 ick Septic Service, LLC 1205 LaBeaux Ave NE • Phone: 763-497-2764 St. Michael, MN 55376 • Email: duaneseptic@centurylink.net DATE (- 6.-Z 3 INVOICE Pumping Fee: $ „, ...._ Name: / 5a Lie- :0 I Psi Long Pull Fee: Address: ZoGo r_-.1--x p,1 (c, Other Repairs. City/State/Zip: 1),ANvte it' Lovv5 LA, icc, Total Cost of Se 'ce: Payment Method: ❑ Check ❑ Cash ❑ Credit 0/5:0-;) _._.____.) 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: t p 0 Yes 3'1�10 + ❑ Yes es ❑ Yes No ❑Septic/holding Tank#2 Gallons: ,a c� ❑ Yes C� No ❑ Yes [moo ❑ Yes ..1 'No ❑ Pretreatment Tank Gallons: ❑ Yes 0 No ❑ Yes CINo ❑ Yes ❑ No El Pump Tank ,,� Gallons: �,� ❑ Yes .""No ❑ Yes L" No ❑ Yes No LQ How Accessed:❑Maintenance Hole Scum/Sludge Measured Maintenance Holes SecurelyReplaced: �,.�' p Reason For Pumping: 0 Other(see attached) 0 Yes Le Pr-Ces ❑ No MOO O vt+ Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., cracked tanks, missing baffles, brokenn Avers,etc,?If so, explain In comments b low. E Tank#1 0 Yes -t10 Tank#2 ElYes a'No Pump Tank ❑ Yes Lo System CI Structural integrity ❑ Structural integrity ❑ Structural integrity l3`Mound ❑ Risers leaking 0 Risers leaking ❑ Risers leaking ❑ Elevated drainfield ❑ Baffles ❑ Baffles ❑ Baffles 0 Pressure bed 0 Non-domestic waste 0 Non-domestic waste ❑ Electrical issues ❑Trenches ❑ Non-domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? 0 Yes 0 No Comments: }r) .,�4- -� p-c°W,WLe't c ) .i i- e . Pk-friP vt k: s b,,i•e...v-- 1 I C4 4- Jim etc, Disposal: Q'Cand Application: 0 Wastewater Treatment Plant Disposal Site: ` /4 Lime: "'.-''' Gallons "a (ca,c> Plowed: ❑ Yes ElIC(o Time: 1 ae ( Temperature: i S, 3 pH: I! >12 Li Time: (a 3 Temperature: t S', 'j pH: II. '3 >12 C ..� r THANKS! .• * 7 r