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Ende Septic Service, LLC, MPCA Lic #L2654 Maintenance Inspection Form 24910 Territorial Road • Rogers, MN 55374 Phone: 763428-4489 ❑ Tristan Brandon ❑ Scott ElKurt ❑ Robert email: info(a,endeseptic.com !� Maintenance ❑ Emergency ❑ OtherDisposal Iocation..4 Land ap ❑ Treatment plant Date: - Z I —; &/ Invoice Name: 1'�Ul/ M C-(!(-V_tA Description: Address: /0 S lG, 6�d Total Cost of Service: City/State/Zip: lr p vt o Payment Method: ❑ Check ❑ Cash ❑ Credit Tank (check if present) Tank leaks below the Tank leaks above the Maintenance hole cover is designed operating designed operating damaged, cracked, depth depth unsecured, or appears to be structurally sound 15�Septic/holding Tank #1 ❑ Yes k-No ❑ Yes A:No ❑ Yes frNo ll Gallons: 1,wo rS $+Septic/holding Tank #2 ❑ Yes EMo ❑ Yes 'rQ-No ❑ Yes @YNo Gallons: ❑ 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? J� Yes ❑ No Access point: LkCover/maintenance hole; if so, were covers secured in place? 'q Yes ❑ No Access point;_B-Inspection pipe; if through pipe, did homeowner sign off ? 9Yes- Q-N 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 AR2No Tank #2 ❑ Yes &No Pump Tank ❑ Yes ❑ No System ❑ Structural integrity ❑ Structural integrity 'ty ❑ Str/mestic ❑ Mound ❑ Risers leaking ❑ Risers leaking ❑ Ris ❑ Elevated drainfield ❑ Baffles El Baffles ❑Ba El Pressure bed ❑ Non -domestic waste ❑ Non -domestic waste ❑ Eles �4 Trenches ❑ Noaste ❑ Ponding/surfacing ❑ Efflleaned? ❑ Other: Comments: