HomeMy WebLinkAbout8-13-24 Septic Pumping ReportSeptic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE �- ( 3- 2 ti
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer ❑ Jim
Nick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
Pumping Fee:
Name: IIVVUIt;t
Long Pull Fee:
Address:
Other Repairs: 6
City/State/Zip:
nny►'�:_ Pt4,'x)0r&It-z
Total Cost of Service-
(`
Payment Method: ❑ Check ❑ Cash ❑ Credit
�Z -7, 0
Tank (check if present)
Tank leaks below the
Tank leaks above the
Maintenance hole cover is damaged,
designed
operating depth
designed operating depth
cracked, unsecured, or appears to be
structurally unsound
B75eptic/holding Tank #1
Gallons:lpco
❑ Yes
I;11�0
❑ Yes
❑ Yes
G71�eptic/holding Tank #2
❑Yes
Cf No
❑Yes C5
Gallons: t 000
No
❑Yes
❑ Pretreatment Tank
Gallo s:
❑ Yes
❑ No
El Yes ❑ No
El Yes ElNo
Pump Tank
Gallons:100 a
❑ Yes
No
ElYes � No
❑ Yes C�No
How Accessed: aintenance Hole
Scum/Slud.ge Measured
�Malnle7n�ance_H`olesSecurely Replaced:
Reason For Pumping:
❑ No
❑ No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
C ked tanks. missing hafflaa hrnhan n /w ate 2 rF a ice;,. _,..
Tank #1 ❑ Yes o
Tank #2 ❑ Yes R1 No
Pump Tank ❑ Yes No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
Z 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/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
Comments:
Disposal: ❑ Land Application: Wastewater Treatment Plant I
Disposal Site:
Lime:
Gallons Z0-910
Plowed: ❑ Yes
❑ No
Time:
Temperature:
pH:
> 12 ❑
Time:
Temperature:
pH:
> 12 0