HomeMy WebLinkAbout03-20-2024 septic pumping reportDVANE�
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE '� - 2'0 i. G1
Maintenance
Maintainer
• Phone: 763-497-2764
Inspection Form
MPC :Lic. #L4286
Jim
❑ Nick
• Email: duaneseptic@centurylink.net
I10Lyle] W
Pumping Fee: 3 s-
p�.���
1 �t3L�
(�-a t �u��
Name:
Ti1a''t-1
Long Pull Fee:
Address: t)I A
Cr
Other Repairs:
City/State/Zip:
O
Total Cost of Service: _
Payment Method: ZrCheck ❑ Cash
❑ Credit
Tank leaks below the
Tank leaks above the
Maintenance hole cover is damaged,
Tank (check if present)
designed operating depth
designed operating depth
cracked, unsecured, or appears to be
structurally
unsound
Septic/holding Tank #1
n
�-
Gallons: /W
ElYes
No
ElYes � No
❑ Yes
❑ No
❑ Septic/holding Tank 42
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Pretreatment Tank
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
f,.
Pump Tank
ZN
ZN
Gallons: -;- LV
❑ Yes
❑ Yes
❑ Yes
,el No
I
How Accessed:Z Maintenance Hole
Scum/Sludge Measured
Maintenance Holes Securely Replaced:
Reason For Pumping:
El Other (see attached)
El Yes RJ No
-rinaYes ❑ No
./
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
_,,2�5'cked tanks, missing baffles, broken covers, etc.? If so, explain in comments 40ew.
Tank #1 ❑ Yes o
Tank #2 ❑ Yes ❑ No
Pump Tank ❑ Yes o
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
❑ Mound
❑ Risers leaking
❑ Risers leaking
❑ Risers leaking
1:1,F,14alted drainfield
❑ Baffles
❑ Baffles
❑ Baffles
K 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: ❑ Land Application: Yd wastewater Treatment Plant V_,A 7�"t o 1;.
Disposal Site:
Lime:
Gallons
Plowed: ❑ Yes ❑ No
Time:
Temperature:
pH: > 12 ❑
Time:
Temperature:
pH: > 12 ❑