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HomeMy WebLinkAbout 4-23-24 septic pumping report cher Maintenance Inspection Form MPC Lic. #L4286 Maintainer INIKJim ❑ Nick Service, LLC • Phone: 763-497-2764 Beaux Ave NE ael, MN 55376 • Email: duaneseptic@centurylink.net ki- Z,j- & INVOICE Fee: II a,5v Name: Act ,,, pot Li I Fee: Address: ob 61.1-, S-k,e., At :pairs: City/Statedip: ©rvyt-ci St of Service: Payment Method: ❑ Check ❑ Cash ❑ Credit i/ iji ). Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, Ik(check if present) cracked,unsecured,or appears to be designed operating depth designed operating depth structurally unsound hoing Tank#1 (U ❑ Yes Et< 0 Yes 12-- o 0 Yes 12'‹ hol�diU�ank#2 0 Yes No 0 Yes ❑ ❑ Yes G�No fitment Tank ❑ Yes 0 No 0 Yes 0 No 0 Yes 0 No rank ❑ Yes 0 No 0 Yes 0 No 0 Yes 0 No ;ssed:©Maintenance Hole Scum/Slud a Measured Maintenance les Securely Replaced: Reason For umping: 9 P ❑Other(see attached) 0 Yes Ca'No Yes 0 No Did you identify any operational issues or unsafe condition .white assessing the sewage tanks In this system, I.e., ed tanks,missing baffles,broken rs,etc.?If so, explain In comments below. ❑ Yes Wao Tank#2 ❑ Yes o Pump Tank ❑ Yes ❑ No System Structural integrity 0 Structural integrity 0 Structural integrity 0 Mound 3isers leaking 0 Risers leaking ❑ Risers leaking 0 Eleva d drainfield 3affles 0 Baffles 0 Baffles 0 P sure bed Jon-domestic waste 0 Non-domestic waste 0 Electrical issues renches ❑ Non-domestic waste 0 Ponding/Surfacing ❑ Effluent Filter/screen 0 Other: Cleaned? 0 Yes 0 No its: Disposal: 0 Land Application: Clt Wastewater Treatment Plant ki„ga4,:Viswti Site: Lime: Gallons Plowed: 0 Yes 0 No Temperature: pH: >12 0 Temperature: pH: >12 0 ,. , *AV THANKS! . . ...$,