HomeMy WebLinkAboutSeptic pumping 2024Jim Eicher
D
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE I - l l - Z `i
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer ❑ Jim
*Nick
• Phone: 763-z+ui 2 %
• Email: duaneseptic@centurylink.net
INVOICE
Pumping Fee:
Name:
L
1�
Long Pull Fee:
Address:
�55
Other Repairs:
City/State/Zip:
d,ror�o
Total Cost of Se rvi
\ka y
Payment Method: ❑ Check [I Cash
El Credit
u3�.so
I ot,
Tank leaks below the
Tank leaks above the
Maintenance hole cover Is damaged,
Tank (check if presen
)—�
designed
operating depth
designed operating depth
cracked, unsecured,
or appears to be
structural)
unsound
USeptic/holding Tank #1
❑ Yes
No
�,�
El Yes P "o
❑ Yes
Ba I CO
Gallons: z p
pKeptic/holding Tank #2
❑ Yes'
°
❑ Yes
❑Yes
❑'�lo
Gallons L V
❑ Pretreatment Tank
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
ElNo
YPump Tank
El
1°0
❑ Yes �
❑ Yes
Z?' o
Gallons:
G2
Y
How Accessed: aintenance Hole
Did
Scum/Sludge Measured
Maintenance Holes Securely Replaced:
Reason For Pumping:
❑ Other (see attached)
❑ es ❑ No
1201es ❑ No
f
%,
you identify any operational issues or unsafe coed/bons while assessing the sewage tanks in this system, 1. e.,
cracked tanks, missing baffles, broken covers, etc.) Ifso, explain in comments below.
Tank #1
❑Yes
o
Tank #2
El Yes
o
Pump Tank ❑Yes D o
System
❑
Structural integrity
❑Structural
Integrity
❑Structural integrity
ound
❑
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: El Land Application: ❑Wastewater Treatment Plant
Disposal Site:
AdjL
Lime:
Gallons
Plowed: El Yes
❑
No
Time:
Temperature:
pH:
>
12 ❑
Time:
Temperature:
pH:
>
12 0