HomeMy WebLinkAbout4260 6th Maintenance Inspection FormDUAN��
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
Maintenance Inspection F L4286
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A Lic.
Maintainer
Duane
Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
INVOICE
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Pumping Fee:
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Name: // __� �5 S�� .
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C.�v,
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Long Pull Fee:
Address: C 2 O C Q
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Other Repairs: �0
City/State/Zip:
Total Cost of Service:
Payment Method: ❑ Check ❑ Cash
❑ Credit
A
Maintenance hole cover Is damaged,
Tank (check if present)
Tank leaks below the
designed operating depth
Tank leaks above the
designed operating depth
cracked, unsecured, or appears to be
structural) unsound
Septic/holding Tank #1
❑ Yes
BINo
❑ Yes Cho -
❑ Yes
Leo
Gallons: /,,-2,j'�D
21�e_p_tic/holding jank #2
❑ Yes
[J -No
❑ Yes ❑INV
❑ Yes
Gallons: /114a
❑ Pretreatment Tank
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
Gallons:
B-ru—mp Tank
Gallons:
❑ Yes
I�'No
❑ Yes O No
El
T.1 No
Id y
How Accessed: 12,91aintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
❑ Other (see attached) ❑ Yes .11-6— 1 IT ❑ No I -�✓��
Did you Identify any operational issues or unsare conditions while assessing the sewage tanks In this system, I.e.,
vnhin /n —mantc halaw_
Tank #1 ❑ Yes o
Tank #2 ❑ Yes FIMO
Pump Tank ❑ Yes o
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 F' en
❑ Other:
Cleanedt ❑ Yes ❑ No
Comments:
Disoosal: ❑ Land Application: tJJ Wastewater Treatment Plant
Disposal Site:
Lime:
Gallons
Plowed: ❑ Yes
❑ No
Time:
Temperature:
pH:
> 12 ❑
Time:
Temperature:
pH:
> 12 ❑
gAME
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