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HomeMy WebLinkAbout06-08-2023 Septic Maintenance Inspection Jim Eicher Maintenance Inspection Form MPCA Lic. # 654 Jtar Maintainer I I Jim '7 I I Duane '-** DuRNEW Nick A 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: 0_ ' i►� ,( , i- 12' f Long Pull Fee: Address: '° Other Repairs: City/State/Zip: Total Cost of Se ce: j Payment Method: ❑ Check ❑ Cash ❑ Credit 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 c/holding Tank#1 ❑ Yes Gallons: ❑ Yes CI Yes ❑ No -7 - Cl ptic/holding Tank#2 Gallons:,--7 ❑ Yes r�-'�10 ❑ Yes C'No O Yes ❑ No ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ElNo ❑ Pump Tank Gallons: ❑ Yes ❑ No ❑ Yes ClNo 0 Yes ❑ No How Accessed:❑Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: tt tv, vvv vt0c Other(see attached) O Yes E 11 ❑ Yes ❑ No i 1 Did you identify any operational Issues or unsafe conditions while assessing the sewage tanks in this system,i.e,, ked tanks,missing baffles,broken covers,etc.?If so, explain In comments below. Tank#1 ❑ Yes roo c Tank#2 ❑ Yes Pump Tank 0 Yes D No ^ System ❑ Structural integrity D Structural integrity ❑Structural integrity ❑ Mound ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield ❑ Baffles ❑ Baffles 0 Baffles ❑ Press re bed ❑ Non-domestic waste ❑ Non-domestic waste 0 Electrical issues nches 0 Non-domestic waste 0 Ponding/Surfacing ❑ Effluent Filter/screen El Other: Cleaned? El Yes El No Comments: Disposal: © Land Application: ❑Wastewater Treatment Plant Disposal Site: f Lime: '".---- Gallons ( Plowed: 0 Yes EfICIT Time: /O ti f Temperature: 12,,7 _ pH: 1 2,,, 1 >12 ET— Time: (i 20 Temperature: ( 3,. '5 pH: 1 L. "- >12 7"--- . t 'r'. 0 ...� @MO THANKS!Q - '437, . ,, f 140 " 1_`