HomeMy WebLinkAbout5-28-24 septic inspectionEnde Septic Service, LLC, MPCA Lic #L2654
24910 Territorial Road • Rogers, MN 55374
Phone: 763-428-4489
email: info(&endeseptic.com
'F Maintenance ❑ Emergency ❑ Other
Maintenance Inspection Form
❑ Tristan (56Brandon ❑ Scott ❑ Kurt ❑ Robert
Disposal location: )j Land ap ❑ Treatment plant
Date: 5 . a 9 a
Invoice
Name:
Description:
Address: l f- KCL
Total Cost of Service:
City/State/Zip: QV -Ono
Payment Method: ❑ Check ❑ Cash ❑ Credit
Tank (check if present)
Tank leaks below the
Tank leaks above the
Maintenance hole cover is
❑ S rural integrity
designed operating
designed operating
damaged, cracked,
❑ Risers aking
depth
depth
unsecured, or appears to be
❑ Baffles
❑ Baffle
❑ Baffles
structurally sound
eptic/holding Tank #1
❑ Yes El No
❑ Yes 11 No
❑ Yes El No
ons:
❑ Non-domesti aste
❑ Ponding/surfacing
❑ Septic h ding Tank #2
❑Yes []No
❑Yes ❑ No
❑Yes ❑ No
Gallons:
❑ Yes ❑ No
❑ Pretreatment Ta
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
❑ Pump Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
Did you measure the accumulation of scum and sludge?,R'.Yes ❑ No
Access point: 19 Cover/maintenance hole; if so, were covers secured in place? '9 Yes ❑ No
Access point: ❑ Inspection pipe; if through pipe, did homeowner sign off ? ❑ Yes ❑ No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cracked tanks, missing baffles, broken covers, etc.? If so, explain in comments below.
k #1 ❑ Yes []No
ank #2 ❑ Yes ❑ No
Pump Tank ❑ Yes ❑ No
System
❑ S rural integrity
❑ ctural integrity
❑ ctural integrity
Mound
❑ Risers aking
❑Ris leaking
❑Ris leaking
Elevated drainfield
❑ Baffles
❑ Baffle
❑ Baffles
❑ Pressure bed
❑ Non -domes ' waste
❑ Non -dome 'c waste
❑ Electrical ues
❑ Trenches
❑ Non-domesti aste
❑ Ponding/surfacing
❑ Effluent filter cleaned?
❑ Other:
❑ Yes ❑ No
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