HomeMy WebLinkAbout06-29-2023 Septic Maintenance Inspection Jim Eicher Maintenance Inspection Form
:4) MPCA Lic. # 654
4 Maintainer [ l Jim
it-dial I 1 Duane
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MAIMS� [42Nick
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Septic Service, LLC • Phone: 763-497-2764
1205 LaBeaux Ave NE
St. Michael, MN 55376 • Email: duaneseptic@centurylink.net
DATE Co" 21 2 3 INVOICE
Pumping Fee:
Name.AA � ,�,,�
Long Pull Fee: {i e Address:2'74 4 3
Other Re airs: City/State/Zip:
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Total Cost of Servic • Payment Method: ❑ Check ❑ Cash ❑ Credit
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
ptic/holding Tank#1 ❑ Yes l ` No ❑ Yes No ❑ Yes No
Galllons:LOi#? /"
C-f"Septiclholding Tank#2 ID Yes lo ❑ Yes ❑ Na ❑ Yes No
Gallons: i F4'
❑ Pretreatment Tank ❑ Yes El No ❑ Yes ❑ No ❑ Yes ❑ No
Gallons:
Q Pump Tank ❑ Yeso ❑ Yes Cal No ❑ Yes No
Gallons: LE -o
How Accessed: aintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
El Other(see attached) ❑Yes No E"1'es ❑ No y �•'.1-
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system,i.e.,
cracked tanks,missing baffles, broken,povers,etc.?If so, explain in comments iow.
Tank#1 ❑ Yes [2'No Tank#2 ❑ Yes 2'No Pump Tank ❑ Yes re-No System .—
El Structural integrity ❑ Structural integrity ❑ Structural integrity l 'Mound
❑ Risers leaking Cl Risers leaking El Risers leaking ❑ Elevated drainfield
El Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed
El Non-domestic waste ❑ Non-domestic waste ❑ Electrical issues ❑Trenches
❑ Non-domestic waste ❑ Ponding/Surfacing
❑ Effluent Filter/screen ❑ Other:
Cleaned? ❑Yes ❑ No
Comments:
Disposa
l: ❑ Land Application: C3 Wastewater Treatment Plant
Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No
Time: Temperature: pH: >12 ❑
Time: Temperature: pH: >12 ❑
Jo 015040, . lir• t..� C THANKS! ,. . V .._.�
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