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HomeMy WebLinkAbout 5-1-24 septic pumping report icher Maintenance Inspection Form MPot Lic. #L4286 Maintainer Zlim 0 Nick Service, LLC • Phone: 763-497-2764 sBeaux Ave NE iael, MN 55376� • Email: duaneseptic@centurylink.net 57,1..� }"I ,,/� INVOICE g Fee: / �3�•Jo 2��0 �"�(`J Name: IJ co,G(2 It i 0-Ut h.� ill Fee: 2� 2-i Address: 100,3 C©A- roe-0-1 pi_ epairs: City/State/Zip: Q CD,1b Est of Service: Payment Method: ❑ Check ❑ Cash ❑ Credit 4 Li(gls-D. Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, nk(check if present) designed operating depth designed operating depth cracked,unsecured,or appears to be structurally unsound�nd /holding Tank#1 ❑ Yes Er o ❑ Yes �1No ❑ Yes .B"No 1(511 /holdip Tank#2 l 0 ❑ Yes Q No 0 Yes No 0 Yes 1r No atment Tank 0 Yes 0 No 0 Yes 0 No 0 Yes 0 No Tagk_,a„ 0 Yes 0 Yes to 0 Yes l2 No essed:C7Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason Fo Pumping: ❑Other(see attached) 0 Yes 17 No g4s 0 No Did you identify a operational issues or unsafe conditions while assessing the sewage tanks in this system,I.e., cked tanks,missing baffles,broken s,etc.?If so, explain in comments-below. ❑ Yes No Tank#2 ❑ Yes - No Pump Tank 0 Yes - No System Structural integrity 0 Structural integrity 0 Structural integrity la"Pound Risers leaking 0 Risers leaking 0 Risers leaking 0 Elevated drainfield Raffles 0 Baffles 0 Baffles 0 Pressure bed Von-domestic waste ❑ Non-domestic waste 0 Electrical issues 0 Trenches ❑ Non-domestic waste 0 Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑Yes 0 No its: Disposal: 0 Land Application: ❑WastewaterTreatment Plant jivp tie/IQ Site: Lime: Gallons Plowed: 0 Yes 0 No Temperature: pH: >12 0 Temperature: pH: >12 0 ,, Q.fi� THANKS! . , Me