HomeMy WebLinkAboutSeptic Pumping 9.9.24Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE 5 - % ,,)-q
Maintenance Inspection Form
VCim,
ic.#L4286
Maintainer
❑ Nick
• Phone: 763-497-2764
• Email: duaneseptic9centurylink.net
INVnICF
Pumping Fee-
Name:
00 kl 10
Long Pull Fee:
Address:
6.
Sk
f 4 wvj
(2
Other Repairs:
City/State/Zip:
Total Cost of Service:
Payment Method: ❑ Check ❑ Cash
❑ Credit
Tank (check if present)
Tank leaks below the
Tank leaks above the
Maintenance hole cover is damaged,
cracked, unsecured, or appears to be
designed operating depth
designed operating depth
structural)
unsound
eptic/holdin Tank #1
❑ Yes
No
❑ Yes �
❑ Yes
f_lo
Gallons: . Z j-o
tic/holdinngq Tank #2
Gallons: /i s U
❑Yes
P_15_0�
❑ Yes No
❑ Yes
r-No
❑ Pretreatment Tank
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
ump Tank
Gallons:
El Yes
No
❑Yes o
El Yes
I
How Accessed: Maintenance Hole
❑
Scum/Sludge Measured
Maintenance les Securely Replaced:
Reason Fox Pumping:
Other (see attached)
❑ Yes ❑
Yes ❑ No
Did you identify an4, operational issues or unsafe conditions w ile assessing the sewage tanks in this system, i.e.,
d tanks, missing baffles, broken c s, etc.? If so, explain in comments_�Oow.
Tank #1 ❑ Yes 2no
Tank #2 ❑ Yes o
Pump Tank ❑ Yes o
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/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
Comments:
Disposal: I ❑ Land Application: ❑ Wastewater Treatment Plant
Disposal Site: r I
Lime:
Gallons
Plowed: El Yes �` No
Time:
Temperature: —
pH: - -- > f2_-❑
Time:
Temperature:
pH: <_ > 12 ❑
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