HomeMy WebLinkAboutSeptic Pumping 7-30-24Jim Eicher
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE 7_ 'so _ 7- V
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer ❑ Jim
Nick
® Phone: 763-497-2764
® Email: duaneseptic@centurylink.net
INVOICE
Pumping Fee:
5V
Nameat I I !c" 5
t 2
Long Pull Fee:
Address: 3 3 (- 0
r
Other Repairs:
City/State/Zip:
ro
Total Cost of ervice:
Payment Method: El Check El Cash El Credit
Tank (check if =present)esigned
Tank leaks below the
Tank leaks above the
Maintenance hole cover is damaged,
cracked, unsecured, or appears to be
operating depth
designed operating depth
structural) unsound
peptic/holding Tank #1
No
Yes No
Gallons: 15W
❑ Yes E�_Pd'6'—
❑ Yes
❑
Septic/holding Tank #2
❑Yes No
(�
❑Yes No
El Yes rl <
Gallons:
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
ump Tank
ElYes 0 No
ElYes e<o
❑ Yes 0
Gallons:
How Accessed: &Maintenance Hole
Scum/Slu Measured
Maintenance Holes Securely Replaced:
Reason For Pumping:
❑ Other (see attached)
C'Yes ❑ No
es ❑ No�ont�-vv4-
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cracked tanks, missing baffles, broken 4overs, etc.? if so, explain in comment�w.
Tank #1 ❑ Yes o
Tank #2 ❑ Yes No
Pump Tank ❑ Yes No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
ound
❑ 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/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
Comments:
Disposal: ❑ Land Application: 1L1�wastewater Treatment Plant
Disposal Site:
Lime:
Gallons 2
Plowed: ❑ Yes ❑ No
Time:
Temperature:
pH: > 12 ❑
Time:
Temperature:
pH: > 12 ❑
Prof
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