HomeMy WebLinkAbout04-19-2023 Septic Maintenance Inspection 1
Jim Eicher Maintenance Inspection Form
iffh MPCA Lic. # 654
' Maintainer Jim
it!„, 1.J��� f I Duane
Nick
DVA IS
Septic Service, LLC = Phone: 763-497-2764
1205 LaBeaux Ave NE St. Michael, MN 55376 • Email: duaneseptic@centurylink.net
DATE q' ( or - #2-. INVOICE
Pumping Fee: 3,7_ Name: G e{,r
Long Pull Fee: Address: /Les.° A 6 6, r,ril,‘ ek
Other Repairs: r�-1 City/State/Zip: 2-10 5-356 OP
Z ?o — eA0" 1--"L j'TN I/ ea J4rcef1 ftaCry
Total Cost of Service: pur. `-, 4V r't o P thod: ❑ Check ❑ Cash redit
t572- 4- - ?. 1U — inw. j [ iCo ,•)1.1., :,.0.r,,: ,
Maintenance hole cover is damaged,
Tank leaks below the Tank leaks above the cracked,unsecured,or appears to be
Tank(check if present) designed operating depth designed operating depth
structurally unsound
t eptic/holdi .Tank#1
D Yes Zl< ❑ Yes CS N/o IW Ke—s ❑ No
Gallons: e 0.
fie tic/holding Tank#2 ❑ Yes No Yes ❑ No
p ❑ Yes to
Gallons: [0-00
❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No
Gallons:
m Tank / -n No ❑ Yes 'r No
Pu p ❑ Yes �d"No ❑ Yes
Gallons: [0V0 _
How Accessed: Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
_�� �'es El No bct c//r�,� 7,
❑Other(see attached) ❑Yes No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system,i.e.,
racked tanks,missing baffles, broken wavers,etc.?If so, explain in comments below.
Tank#1 ❑ Yes No Tank#2 ❑ Yes l to Pump Tank ❑ Yes 0-No System 1_Mound
❑ Structural integrity ElStructural integrity ❑ Structural integrity
❑ Risers ❑ Risers leaking ❑ Elevated drainfield
Cl Risers leaking leaking❑ Baffles ❑ Baffles ❑ Baffles 0 Pressure bed
❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical issues 0 Trenches
Non-domestic waste ❑ Ponding/Surfacing
El Effluent Filter/screen ❑ Other:
Cleaned? ❑Yes 0 No
Comments: -�- h-4 CG v-.e n-e e.e4 7� PR- re,P 11r_a w►.e.4 t....a,,..3..�--
t5 �
�,, t b e leipoeLs t h —
Disposal: ❑ Land Application: Nastewater Treatment Plant v. ._.AT/L--i,-,..
Disposal Site: I Lime: Gallons Plowed: ❑ Yes ❑ No
Time:
Temperature: pH: >12 ❑
Time:
Temperature: pH: >12 ❑
« .ii �. .Jr4.11P.r.a� C THANKS! C .ll ....",.,,",4A11a
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