HomeMy WebLinkAboutSeptic Maintenance form 6-13-2024Ende Septic Service, LLC, MPCA Lic #L2654
24910 Territorial Road • Rogers, MN 55374
Phone: 763-4284489
email: info(&endeseptic.com
Maintenance ❑ Emergency ❑ Other
Maintenance Inspection Form
❑ Tristan ❑ Brandon ❑ Scott XKurt ❑ Robert
Disposal location: ❑ Land ap ❑ Treatment plant
Date: r,/-/ 1.7 67,q
Tank leaks below the
Invoice
Name: o 44-
rvc(,
Description: ?Rtat Xv s
Address: 7,7,0'5
6 ;h a p n W(n
Total Cost of Service:
City/State/Zip: Mann
PIA/ S5'3 6
Payment Method: ❑ Check ❑ Cash ❑ Credit
Tank (check if present)
Tank leaks below the
Tank leaks above the
Maintenance hole cover is
❑ Structural integrity
designed operating
designed operating
damaged, cracked,
❑ Risers leaking
depth
depth
unsecured, or appears to be
❑ Baffles
❑ Baffles
❑ Baffles
structurally sound
Weptic/holding Tank #1
❑ Yes AgNo
❑ Yes A�No
❑ Yes 11 No
rallons:
❑ Non-domestic waste
❑ Ponding/surfacing
ZSeptic/holding Tank #2
El <,No
❑ Yes 64io
❑ Yes XNo
Gallons:
❑ Yes ❑ No
❑ Pretreatment Tank
❑ 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? ❑ Yes 4'No
Access point: fTCover/maintenance hole; if so, were covers secured in place? JWYes ❑ 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.
Tank #1 ❑ Yes 95No
Tank #2 ❑ Yes RFNo
Pump Tank ❑ Yes ❑ No
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
ZVrenches
❑ Non-domestic waste
❑ Ponding/surfacing
❑ Effluent filter cleaned?
❑ Other:
❑ Yes ❑ No
Comments: