HomeMy WebLinkAboutSeptic maintenance form 9-2024Ende Septic Service, LLC, MPCA Lic #L2654
24910 Territorial Road • Rogers, MN 55374
Phone: 763428-4499
email: info(c cndeseptic.com
❑ Maintenance El Emergency Other
Maintenance Inspection Form
❑ Tristan ❑ Brandon ❑ Scott y
Kurt ❑ Robert
Disposal location:'g Land ap ❑ Treatment plant
Date: 5-36-2_6Zq
Invoice
Name: r4qdk,,J / /et'�OInJ
Description: P. ; ys tcf
Address: "l6 A,b ;n c�m w
Total Cost of Service:
City/State/Zip: Qtphp /??
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
yd Septic/holding Tank #1
❑ Yes No
`
❑ Yes No
\
❑ Yes No
Gallons:
�Septic/holding Tank #2
❑ Yes No
❑ Yes No
❑ Yes �No
allons:
s ❑ No
❑Yes ❑ No
Gallons:
Pump Tank
❑ Yes 1�No
❑ Yes Z No
❑ Yes 4 No
Gallons:
Did you measurg the accumulation of scum and sludge? ❑ Yes )<No
Access point: A Cover/maintenance hole; if so, were covers secured in place? 4Yes ❑ No
i
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.? /f so, explain in comments below.
Tank #1 ❑ Yes kNo
Tank #2 ❑ YesANo
Pump Tank ❑ Yes No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
❑ Mound
❑ 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 cleaned?
❑ Other:
❑ Yes ❑ No
Comments: