HomeMy WebLinkAbout8-21-24 Septic InspectionEnde 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
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Total Cost of Service:
City/State/Zip:
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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: