HomeMy WebLinkAboutSeptic Pumping 7-23-24Jim Eicher
D
Septic Service, LLC
1205 LaBeaux Ave NE
St. Mich+/ael, MN 55376
Maintenance Inspection Form
MPC ic. #L4286
Maintainer Jim
❑ Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
INVOICE
Lim C p- v-
Pumping Fee. �.
Name: e7-_.e (
Long Pull Fee:
Address:
Other Repairs:
City/State/Zip:
0
Total Cost of Serv' e
Payment Method: ❑ Check ❑ Cash ❑ Credit
5 �� �o
')
Maintenance hole cover is damaged,
Tank (check if present)
Tank leaks below the
designed operating depth
Tank leaks above the
designed operating depth
cracked, unsecured, or appears to be
structural) unsound
Septic/holding Tank #1
❑Yes
�i No
❑Yes No
❑ Yes ❑
Gallons:
Septic/holdin�Tank #2
El Yes
I�No
❑ Yes 0-No
El Yes E No
Gallons: L�t✓
❑ Pretreatment Tank
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
Rrf—ump Tank
�
❑Yes 10 /
Gallons: 5vo
❑ Yes
e No
❑ Yes
How Accessed: Maintenance Hole Scum/Sludge Measured Mainte�na�ncee Holes Securely Replaced: Reason For P mping-
❑ Other (see attached) ❑ Yes ❑ No .✓sYes ❑ No
Did you identify a y operational issues or unsafe conditigms while assessing the sewage tanks in is system, i.e.,
acked tanks, missing baffles, broken vers, etc.? If so, explain in commen e/ow.
Tank #1 ❑ Yes RIF r4o 1
Tank #2 ❑ Yes ETNo I
Pump Tank ❑ Yes M No I
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
❑ Risers leaking
134ound
❑ Elevated drainfield
❑ Risers leaking
❑ Risers leaking
❑ Baffles
❑ Pressure bed
❑ Baffles
❑ Non -domestic waste
❑ Baffles
❑ Non -domestic waste
❑ Electrical issues
❑ Trenches
❑ Non -domestic waste
❑ Ponding/Surfacing
❑ Effluent Filter/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
Disposal: ❑ Land Application: Wastewater Treatment Plant
Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No
Time: Temperature: pH: > 12 ❑
Time: Temperature: pH: > 12 ❑
� THANKS!