HomeMy WebLinkAboutSeptic maintenance form 6-18-2024Ende Septic Service, LLC, MPCA Lie #L2654
24910 Tentorial Road • Rogers, MN 55374
Phone: 763-42813489
email: infoCo)endeseptic.com
fMaintenance ❑ Emergency ❑ Other
Maintenance Inspection Form
❑ Tristan Jq Brandon ❑ Scott ❑ Kurt ❑ Robert
( (Disposal location: EI Land ap AQ Treatment plant
Date: —
— a
Invoice
Name:
S e hC,h Q OttwIc&n/p
Description: 7aS,OC t
Address: 37-0-
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( fZd
Total Cost of Service: '45s,, �J
City/State/Zip:
y- n p
Payment Method: ❑ Check ❑ Cash ❑ Credit
;10941
Tank (check if present)
Tank leaks below the
designed operating
Tank leaks above the
designed operating
Maintenance hole cover is
damaged, cracked,
❑ Structural integrity
depth
depth
unsecured, or appears to be
❑ Risers leaking
❑ Risers leaking
❑ Risers leaking
structurally sound
�I Septic/holding Tank #1
❑ Yes No
❑ Yes No
❑ Yes 43 No
allons: I p
❑ Non-domestic waste
❑ Electrical issues
❑ Trenches
❑ Non-domestic waste
❑ Ponding/surfacing
49,Septic/holding Tank #2
❑ Yes No
❑ Yes No
❑ Yes I No
Gallons:
❑ Yes ❑ No
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
($.Pump Tank
❑ Yes O No
❑ Yes 47t No
❑ Yes .@KNo
Gallons:
Did you measure the accumulation of scum and sludge? I&LYes ❑ No
Access point: KCover/maintenance hole; if so, were covers secured in place? Ames ❑ No
Access pointer Inspection pipe; if through pipe, did homeowner sign off ?177er^ff�Tdo
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.? /f so, explain in comments below.
Tank #1 ❑ Yes IkNo
Tank #2 ❑ Yes U -No
Pump Tank ❑ Ye$9LNo
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
A 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 cleaned?
❑ Other:
❑ Yes ❑ No
Comments: