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Ende Septic Service, LLC, MPCA Lic #L2654 24910 Territorial Road • Rogers, MN 55374 Phone:763-428-4489 email: info(a)endeseptic.com Maintenance Inspection Form ❑ Tristan11L.Brandon ❑ Scott ❑ Kurt ❑ Robert I Maintenance ❑ Emergency ❑ Other ,, Disgosal location: qllLand ap ❑ Treatment plant t Date: (p— Z �� .Z Invoice 1 Name: Description: � A Address: �� 0 �i �S a w� Total Cost of Service: City/State/Zip: Dr0 Nd 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 Septic/holding Tank #1 ❑ Yes kNVo ❑ Yes LKNo ❑ Yes .4� No Gallons: �j)Q t S ❑ Septic/holding Tank #2 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: ❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: Pump Tank ❑ Yes Zlo ❑ Yes !$No ❑ Yes I% No Gallons: Did you measure the accumulation of scum and sludge? Jl Yes ❑ No Access point: Cover/maintenance hole; if so, were covers secured in place? '47 Yes ❑ No Access point:d3.istspection pipe; if through pipe, did homeowner sign off ?�B Pla 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 fi�No Tank #2 ❑ Yes 7 No Pump Tank ❑ YeskNo System ❑ Structural integrity grity ❑ Struct/leing ❑ Structural integrity ❑ Mound ❑ Risers leaking ❑ Risers ❑ Risersleaking Elevated drainfield ❑ Baffles ❑ Baffle ❑ Baffles ❑ Pressure bed ❑ Non -domestic waste ❑ Non omestic waste ❑ Electrical issues ❑ Trenches ❑ Non -domestic waste ❑ Ponding/surfacing ❑ Effluent filter cleaned? ❑ Other: ❑ Yes ❑ No Comments: