HomeMy WebLinkAboutSeptic Pumping 7-17-24DV�E�
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE —7-- 1 i ` "
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer U Jim
ick
® Phone: 763-497-2764
® Email: duaneseptic@centurylink.net
INVOICE
Pumping Fee:
Name:
sn
Long Pull Fee:
Address: i
l i
l -Oki
Repairs:
City/State/Zip:
Total Cost of Se ce:
Payment Method: ElCheck El Cash
❑ Credit
j
i 33
Tank (check if presen
Tank leaks below the
Tank leaks above the
Maintenance hole cover is damaged,
cracked, unsecured, or appears to be
designed operating depth
designed operating depth
structural) unsound
Septic/holding Tank #1
Yes
No
Gallons: t:D
❑ Yes No
❑ Yes No
❑
EI-Septic/holding Tank #2
El Yes No
❑ Yes No
El Yes
�-
�o
Gallons: t3�
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
Gallons:
Pump Tank
❑Yes No
❑Yes No
❑Yes
No
Gallons: �-J
How Accesseq9f Maintenance Hole
❑ Other (see attached)
Scum/Slu e Measured
d'Yes ❑ Nof
Maintenance oles Securely Replaced:
Yes ❑ No
Reason For Pumping:
i
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cr ked tanks, missing baffles, broken covers, etc.? If so, explain in comments low.
Tank #1 ❑ Yes pllqo
Tank #2 ❑ Yes o
Pump Tank ❑ Yes 2rNo
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
❑ Njgfind
❑ Risers leaking
❑ Risers leaking
❑ Risers leaking
OElevated 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
Comments:
Disposal: 21Land Application: ❑ Wastewater Treatment Plant
Disposal Site:
Lime:
Gallons 22,_ r_-0
Plowed: ❑ Yes o
Time: 3 33--7
Temperature:
pH: t z _-t > 12
Time: L(Z 7
Temperature: L `1,`C
pH: \ 1, -& > 12 ❑
01
IN
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