HomeMy WebLinkAboutSeptic- 2023 Maintenance, 4235 6thJim Eicher
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
n,&TF S-- 30 z
Maintenance Inspection Form
MPCA Lic. # 654
Maintainer Jim
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Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
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Pumping Fee:
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Name 44 4 "SC
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Long Pull Fee:
Address: IAla 3 s
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Other Repairs:
City/State/Zip:
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Total Cost of Seryie�
Payment Method: 2 Check
❑ Cash ❑ Credit
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350
nk leaks below the
Tank leaks above the
Maintenance hole cover is damaged,
Tank (che ' resent)
designed operating depth
designed operating depth
cracked, unsecured, or appears to be
structural) unsound
Ea-'Septic/holding Tank #1
El Yes No
El Yes ❑�lo
❑Yes ❑ No
Gallons: � v c�
ptic/holding Tank #2
❑ Yes VINo
❑ Yes ❑) o
❑ Yes ❑ No
Gallons: f Lgna
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
❑ Pump Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
How Accessed: El Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Z'4
on For Pumping:
t/ ! .t� Other (see attached) ❑Yes CJ No El Yes ❑ No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
rrarked ranks. missino 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
iKTrenches
❑ Non -domestic waste
❑ Ponding/Surfacing
❑ Effluent Filter/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
Comments:-��,o�v( V��.. �,�FS ✓fix 1 o�-e Gam{'
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Disposal: ❑ Land Application: ❑ Wastewater Treatment Plant
Disposal Site:
Lime:
Gallons
Plowed: ❑ Yes ❑ No
Time:
Temperature:
pH: > 12 ❑
Time:
Temperature:
pH: > 12 ❑
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