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HomeMy WebLinkAbout9-14-23 Septic Pumping ReportJim Eicher Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE Maintenance Maintainer • Phone: 763-497-2764 Inspection Form MPCA Lic. #L4286 ElJim ❑ Nick • Email: duaneseptic@centurylink.net INVOICE Pumping Fee: -, -, - Scum/Sludge Measured Name: r* Long Pull Fee: ❑ Other (see attached) Address: ❑ Yes ❑ No ❑ Mound ❑ Risers leaking Other Repairs: r ❑ Risers leaking City/State/Zip: ❑ Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed ❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical issues Total Cost of Service: j Payment Method: ❑ Check ❑ Cash ❑ Credit ❑ Non-domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, Tank (check if present) designed operating depth designed operating depth cracked, unsecured, or appears to be structurally unsound ❑ Septic/holding Tank #1 Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Septic/holding Tank 42 Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Pump Tank Gallons: ❑ Yes ❑ No ElYes ❑ No ❑ Yes ❑ No How Accessed: ❑ Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: ❑ Other (see attached) ❑ Yes ❑ No ❑ Yes ❑ No ❑ Mound Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., cracked tanks, missing baffles, broken covers, etc.? If so, explain in comments below. Tank #1 ❑ Yes ❑ No Tank #2 ❑ Yes ❑ No Pump Tank ❑ Yes ❑ No System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity ❑ Mound ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield ❑ Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed ❑ Non-domestic waste ❑ Non-domestic waste ❑ Electrical issues ❑ Trenches ❑ Non-domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑ Yes ❑ No Comments: Disposal: -Enand Application: ❑ Wastewater Treatment Plant Disposal Site: w , Lime: Gallons 2_6 o U Plowed: ❑ Yes —0 -No Time: 3 ', t ?) Temperature: pH: i .: - > 12 -❑ Time: {4 , 3 Temperature: pH: > 12 ❑ ,✓~-'�-� �`'- .sem- ,�-'�-� �`'� sem..