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HomeMy WebLinkAbout 5-2-24 septic pumping report icher Maintenance Inspection Form MPC A Lic. #L4286 > Maintainer Jim ❑ Nick Service, LLC • Phone: 763-497-2764 aBeaux Ave NE lad, MN 55376 • Email: duaneseptic@centurylink.net 5- 7/Z i1/ INVOICE g Fee: /J 0 Name: / —E�,202 J jb(;a (,- l�viJ Er.,, �` 55'rL t Sie ph' cn Le...., ill Fee: Address: D epairs: City/State/Zip: 0ror' t) )st of Service: _ _ Payment Method: ❑ Check ❑ Cash ❑ Credit Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, ink(check if present) cracked, unsecured,or appears to be designed operating depth designed operating depth structurally unsound ;MoldingTank#1 ❑ Yes 0 No ❑ Yes No ❑ Yes No /holding Tank#2 ❑ Yes o ❑ Yes ❑ Yes C<No atment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Tank ❑ Yes E.:1,110 ❑ Yes Cr No ❑ Yes No ;essed: aintenance Hole Scum/Sludge Measured Maintena�nc Holes Securely Replaced: Reason For Pumping: ❑Other(see attached) ❑Yes s"No -t"1 Yes ❑ No i Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., creed tanks,missing baffles, broken cov etc.?If so, explain in comments low. ❑ Yes f iol o Tank#2 ❑ Yes 0'No Pump Tank ❑ Yes iii,eFlo System Structural integrity ❑ Structural integrity ❑ Structural integrity Mound Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed Non-domestic waste ❑ Non-domestic waste ❑ Electrical issues ❑ Trenches ❑ Non-domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑Yes ❑ No nts: Disposal: ❑ Land Application: ,17Wastewater Treatment Plant IA,e_N i`.e,-i t; � LI Site: Lime: Gallons Plowed: ❑ Yes ❑ No Temperature: pH: >12 ❑ Temperature: pH: >12 ❑ �� ,,.,.� QC. THANKS! ,., • 0��