HomeMy WebLinkAboutSeptic Pumping 9.5.24Jim Eicher
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE)
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer ❑ Jim
Ick
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
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Pumping Fee:
Name:
Long Pull Fee: -
Address:
3 68
Other Repairs:
City/State/Zip:
E)V'G)AO
Total Cost of
wr11—
Payment Method: ❑ Check ❑ Cash
❑ Credit
Tank (check if pr
ank leaks below the
Tank leaks above the
Maintenance hole cover is damaged,
cracked, unsecured, or appears to be
designed operating depth
designed operating depth
structurally
unsound
Septic/holding Tank #1
Gallons: �p9,�
❑ Yes
�
❑ Yes ❑" No
El Yes
Er o
Septic/holding Tank #2
El Yes
Gallons:1900
121'No
❑ Yes 0 No
❑ Yes
No
❑ Pretreatment Tank
Gallons:
❑ Yes
IDNo
ElYes ❑ No
❑ Yes
I]No
Pump Tank
Gallons: C�[fJ
❑ Yes
No
El Yes No
❑ Yes
C3' No
I
How Accessed: Maintenance Hole
Scum/Sludge Measured
Maintenanncce Holes Securely Replaced:
Reason For Pumping:
El Other (see attached)
Comes ❑ No
Yes ❑ No
k '4
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
racked tanks, missing baffles, broken covers, etc.? If so, explain in comment�,below.
Tank #1 ❑ Yes VNo
Tank #2 ❑ Yes o
Pump Tank ❑ Yes 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: ❑ Land Application: -R' astewater Treatment Plant H
Disposal Site:
Lime:
Gallons Z 5-D —,I
Plowed: ❑ Yes ❑ No
Time:
Temperature:
pH: > 12 ❑
Time:
Temperature:
pH: > 12 ❑
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