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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 d MAIMS� [42Nick DVAN�� 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: .1),,Ny,„p ...4.z._ Itgb,,..,,-.0 OTD,A0 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 .._.� _ a .*LARILW ;,. "%o* -._...111111/1 ""'. .-1M0.4‘VP OP*