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HomeMy WebLinkAbout200 Hollander Rd, Maintenance Inspection Form, Aug 2023Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 neTIF i- im _1) t Maintenance Inspection Form MPCA Lic. #L4286 Maintainer Jim Duane Nick • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net f kw' 0 T914 Pumping Fee: Lei - caS' Name: S vv Long Pull Fee: Address Other Repairs: City/State/Zip: t� rr-t>✓�J Total Cost o ervice: Payment Method: ❑ Check ❑ Cash ❑ Credit c�f "1' 7 Z p %P,,� Tank (c '-presea 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 structurally unsound ErS-eptic/holding Tank #1 ❑ Yes nf No ❑ Yes C-f�- ❑ Yes O- lo Gallons: a f--Lp.� 13_ Septic/holding Tank #2 ❑ Yes C(No ❑ Yes � ❑ Yes �o Gallons: � 5-Zy.� ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ump Tank ❑ Yes a No ❑ Yes KIN o ❑ Yes B� Gallons: / S-L-2 How Accessed: Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: ❑ 1'vl,fc-. T" El Other Other (see attached) ©❑ No Ca-les No n Did you Identify any operational Issues or unsafe conditions while assessing the sewage tanks In this system, I.e., L,mrf t>n Lc miccinn hafflochrnitPn rnvarc_ Ptr.7 rf Sn. Pxnlaln In comments_ below. Tank #1 ❑ Yes o Tank #2 ❑ Yes No 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 ❑ tiar --'domestic waste ❑ Ponding/Surfacing EI-Effluent Filter/ reen ❑ Other: Cleaned? Cnes ❑ No Comments: Disposal: 3"Land Application: ❑ Wastewater Treatment Plant Disposal Site: Lime: Gallons 6LV D Plowed: ❑ Yes L'Jo Time: ) p 'L- Time: 11Temperature: Temperature: ref <7 f � , l pH: pH: I Z > 12