HomeMy WebLinkAbout825 Hunt Farm Rd Maintenance Inspection Form 2023Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE Si- -Z-2"3
Maintenance Inspection Form
MPCAL4286
Maintainer = Jim
Duane
Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
intvnirF:
Pumping Fee:
Name: ti
Long Pull Fee:
Address:
o
Other Repairs:
City/State/Zip:
pu-u '&'0
Total Cost of Servi
�'
Payment Method: ❑ Check ❑ Cash
❑ Credit
Tank (check if present)
Tank leaks below the
Tank leaks above the
Maintenance hole cover Is damaged,
cracked, unsecured, or appears to be
designed operating
depth
designed operating depth
structural)
unsound
ptic/holding Tank #1
❑Yes
C�t-iVo
❑Yes No
❑Yes
No
Gallons: t Z Si?
Ej'geptic/holding Tank #2
Yes
n
Gallons: I -a j)-v
❑
No
❑ Yes No
❑ Yes
t=T No
❑ Pretreatment Tank
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
ump Tank
❑ Yes
l9' No
❑ Yes
❑ Yes
E;I_i oo
Gallons: 1 2 S-b
..01No
M
How Accessed. Maintenance Hole
Scum/Sludge Measured
Maintenance Holes Securely Replaced:
Reason For Pumping:
❑ Other (see attached)
❑ Yes ❑ o
❑ No
Ylst: 'r,� 4 -
Did you Identify any operational Issues or unsafe conditions while assessing the sewage tanks In this system, 1. e.,
-cracked tanks, missing baffles, broken covers, etc.? Ifso, explain In commentsbelow.
Tank #1 ❑ Yes 2rNo
Tank #2 ❑ Yes o
Pump Tank ❑ Yes No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural Integrity
ound
❑ 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: and Application: ❑ Wastewater Treatment Plant
Disposal Site:
Lime:
Gallons
Plowed:
❑ Yes ❑-N6
Time:
3 -7
Temperature: ) of
pH:
-a , 2-- > 12
Time:
9 2
Temperature: j
pH:
t Z, _2 > 12 El -
moor-_- sue. -�.'"`" ,.•�, .rr- sue,,