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HomeMy WebLinkAbout1025 Heritage Ln, Maintenance Inspection form, Aug 2023Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE �-- Z & '2-3 Maintenance Inspection Form MPCA L4286 Maintainer F --- I Jim F-1 Duane 9PTIck • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Pumping Fee: (�6-- Name: rAk s Pa t%-A Long Pull Fee: Address: 0 z T- (r� - Other Repairs: City/State/Zip: C ✓Gv., Total Cost of S Payment Method: ©-Check ❑ Cash 0 Credit --4!v115 vl (�5S Tank (check if present) Tank leaks Zlow the Tank leaks above the Maintenance hole cover Is damaged, cracked, unsecured, or appears to be designed operating depth designed operating depth structural) unsound eptic/holding Tank #1 Gallons: f Z Ali ❑ Yes � ❑ Yes � ❑ Yes Q No Septic/holding Tank #2 ❑Yes Q40, ❑Yes ©No ❑Yes No Gallons: j 2 5-;,V ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Bump Tank Gallons: / 2 $--V ❑ Yes o ❑ Yes ❑ Yes CVO i How Accessed: Maintenance Hole Scum/Sludge Measured Maintenanice, Holes Securely Replaced: Reason For Pumping: El Other (see attached) rrYes//❑ No 1 Yes ❑ No f✓l_°L •%,. 4— old you identify any operational Issues or unsafe conditions while assessing the sewage tanks In this system, I.e., _.-cracked tanks, missing baffles, broken ,mars, etc.? If so, explaln In commentSbelow. Tank #1 ❑ Yes 6No Tank #2 ❑ Yes ElAo Pump Tank ❑ Yes o System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity ound ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfleld ❑ 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: 12JILand Application: ❑ Wastewater Treatment Plant Disposal Site: j Lime: Gallons Z Y40 Plowed: ❑ Yes R'No Time: j d0" 7 Temperature: c pH: > 12 0— Time: o Temperature: `3. ;f� pH: t > 12 E