HomeMy WebLinkAboutSeptic Pumping 7-25-24Jim Eicher
D °
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer P Jim
Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
INVOICE
Pumping Fee:
Name:,
1 Z : c�
q(
Long Pull Fee:
Address:
2 0
!�.r
Other Repairs:
City/State/Zip:
Total Cost of rvice:
Payment Method:
Check
❑ Cash
❑ Credit
Maintenance hole cover is damaged,
Tank (check if present)
Tank leaks below the
Tank leaks above the
cracked, unsecured,
or appears to be
designed operating depth
designed operating
depth
structurally
unsound
optic/holding Tank #1
❑ Yes No
❑ Yes
❑ x0—
❑ Yes
�,
Gallons: 13.,ao
Septic/holding Tank #2
❑Yes P�" No
❑Yes
C3" No
El Yes
L7,o
Gallons: 13�
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
❑ No
Gallons:
ClPa�ump Tank
❑Yes ®No
El Yes
CT No
El Yes
��lo
Gallons: (oo
-low Accessed: EYMaintenance Hole
Scum/Sludge Measured
Maintenance. Holes Securely Replaced:
Reason For Pumping;
El Other (see attached)
Imes ElNo
YYes ❑ No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
..__,__ —:__:__ ur__ a..,i.,... cP, 7 rf — a Wn in rnmmpnts below.
Tank #1 ❑ Yes 2rfqo
Tank #2 ❑ Yes ZI No
Pump Tank ❑ Yes Erno
System
ElStructural integrity
ElStructural integrity
ElStructural integrity
EfMound
❑ Elevated drainfield
❑ Risers leaking
❑ Risers leaking
❑ Risers leaking
❑ 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:
niRnnGaL• ❑ Land Aoolication: ZWastewater I reatment runt — • - -
)isposal Site:
Lime:
Gallons
Plowed: ❑ Yes
❑ No
Temperature:
pH:
> 12 ❑
ime:
Fime:
Temperature:
pH:
> 12 ❑