HomeMy WebLinkAboutSeptic Maintenance March 2024Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376 /
DATE 1( Z • Z_
Maintenance Inspection Form
MPC,A Lic. #L4286
Maintainer eiliim
❑ Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
INVOICE
Pumping Fee: L t) J
Name:
�e Va
O n
Long Pull Fee:
Address:
Other Repairs:
City/State/Zip:
bJ
Total Cost of Service:
Payment Method: ❑ Check ❑ 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
4E7Septic/hoidinq Tank #1
❑ Yes
Z No
❑ Yes O-No
❑ Yes
2f_No
Gallons
O-Septic/holdin9,Tank #2
❑ Yes
)—,r-N o
❑ Yes 11_N0
❑ Yes
Q-- o
Gallons: i 3 u J
❑ Pretreatment Tank
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Pump Tank
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
How Accessed: C3 Maintenance Hole
Scum/Sludge Measured
Maintenance Holes Securely Replaced:
1
Reason For Pumping..
❑ Other (see attached)
❑ Yes a-k-0
-0 Yes ❑ No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cked tanks, missing baffles, brokenlovers, etc.? rfso, explain In comments below.
Tank #1 ❑ Yes o
Tank #2 ❑ Yes No
Pump Tank E.7 Yes ❑ No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural Integrity
❑ Mound
❑ Risers leaking
❑ Risers leaking
❑ Risers leaking
❑ Elevated drainfield
❑ Baffles
❑ Baffles
❑ Baffles
❑ �P assure bed
❑ Non -domestic waste
❑ Non -domestic waste
❑ Electrical Issues
Trenches
❑ Non -domestic waste
❑ PondingfSurtacing
❑ E111uent Filter/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
Comments:
Disposal: ❑ Land Application: ❑ Wastewater Treatment Plant
Disposal Site:
Lime:
Gallons
Plowed: ❑ Yes ❑ No
Time:
Temperature:
pH: > 12 ❑
Time:
Temperature:
pH: > 12 ❑