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4-23-24 septic pumping report
Jim Eicher Maintenance Inspection Form MPC Lic. #L4286 _AP' Maintainer Jim x�MAWS ❑ Nick Septic Service, LLC • Phone: 763-497-2764 1205 LaBeaux Ave NE St. Michael, MN 55376 • Email: duaneseptic@centurylink.net DATE q-, 3•.Rq INVOICE Pumping Fee: ` .-7,� Name: tmq 4� / p (II `1J 1/1 ( I Long Pull Fee: 2� Address: /0o5-- sTu 1s7 PI— Other Repairs: City/State/Zip: --)Total Cost of Servic _ Payment Method: 0 Check 0 Cash 0 Credit 4 Lt 5.___1__Z S:7. Maintenance hole cover is damaged, Tank leaks below the Tank leaks above the cracked,unsecured,or appears to be Tank(check if present) designed operating depth designed operating depth structurally unsoundnd Septic/hold }Tank#1 ❑ Yes -P1 N _ Jo o ❑ Yes ❑ Yes l*o Gallons: /6) 'Septic/holdin,9 TTank#2 0 Yes No 0 Yes Cf'No 0 Yes No Gallons: co ❑ Pretreatment Tank 0 Yes 0 No 0 Yes 0 No 0 Yes 0 No Gallons: ump Tank�� 0 Yes �Iv oC.1� 0 Yes NoLd�No 0 Yes Gallons: ( How Accessed:21Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason F Pumping: ❑Other(see attached) 0 Yes -lam Yes 0 No Did you identify any operational Issues or unsafe conditions while assessing the sewage tanks In this system, I.e., car'eked tanks,missing baffles, brokennc `ers, etc.?If so, explain In comments be�lo `.- Tank#1 ❑ Yes r�tao Tank#2 ❑Yes B'No Pump Tank ❑ Yes ❑- System / ❑ Structural integrity 0 Structural integrity 0 Structural integrity PrWkound O Risers leaking 0 Risers leaking 0 Risers leaking 0 Elevated drainfield O Baffles 0 Baffles 0 Baffles ❑ Pressure bed ❑ Non-domestic waste 0 Non-domestic waste 0 Electrical issues 0 Trenches ❑ Non-domestic waste 0 Ponding/Surfacing ❑ Effluent Filter/screen 0 Other: Cleaned? 0 Yes 0 No Comments: Disposal: 0 Land Application: 0VVastewater Treatment Plant > j,,,Y i v w‘^•. Disposal Site: Lime: Gallons Plowed: 0 Yes 0 No Time: Temperature: pH: >12 0 Time: Temperature: pH: >12 0 Q. THANKS! 10. ,._ ". I L,.."- • ,— , Cyr' ,,, ;— k •"'� q .-- e � ►1'/ , ,--'c-1. s sue. ...r.- �''� sue.