HomeMy WebLinkAbout2024 - 3965 Watertown PumpingSeptic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE 1/ - d 5 - a'(
Maintenance Inspection Form
MPPCA Lic. #L4286
Maintainer � Jim
❑ Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
Pumping Fee:
Name:
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IIV V VIV�-
Long Pull Fee:
Address:
UL-,�
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Other Repairs:
City/State/Zip:
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Total Cost of Service: (-4-1�.�
Payment Method:
ElCheck
ElCash
ElCredit
Tank (check if present)
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
structural) unsound
Septic/holding Tank #1
Gallons: iooD
❑Yes ElNo
❑Yes
❑ No
El Yes
ElNo
❑ Septic/holding Tank #2
Gallons:
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
❑ No
Gallons:
❑ Pump Tank
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
❑ No
Gallons:
How Accessed: ❑ Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
'Other (see attached) ❑ Yes �EA_0 -fn Yes ❑ No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
i- . Lec ,,,icdnn harflec_ hroken covers. etc. ? If so, explaln in comments below.
Tank #1 ❑ Yes O 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
❑ PLe6sure bed
❑ Non -domestic waste
❑ Non -domestic waste
❑ Electrical issues
renches
❑ Non -domestic waste
❑ Ponding/Surfacing
❑ Effluent Filter/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
Comments:
Disposal: ❑ Land Application: u Vvaslewaier iiGauiIV[ n ruin
Disposal Site: Lime: Gallons
Time: Temperature:
Time: Temperature:
Plowed: ❑ Yes ❑ No
pH: > 12 ❑
pH: > 12 ❑
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