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HomeMy WebLinkAboutSeptic Pumping 9.10.24Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE 9 - La - ZN Maintenance Inspection Form MPCA Lic. #L4286 Maintainer ❑ Jim Flick • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net Pumping Fee: Name: IIV V VIIiC Long Pull Fee: Z i �: Address: - Los t� Z$go Other Repairs: City/State/Zip: Total Cost of Servic �'C'v,116 Payment Method: ❑ Check ElCash ❑ Credit II // k o v` 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 Septic/holding Tank #1 Gallons: ©o 0 ❑ Yes ❑ Yes E!�N o ❑ Yes l Septic/holding Tank #2 Gallons: jovO El Yes No / El Yes ❑ No ❑ Yes er—N—o ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No /Pump Tank ❑ Yes No � ❑ � Gallons: t 00 Yes 0-No ❑ Yes Z'No How Accessed: Maintenance Hole Scum/Slu ge Measured Maintenance Holes Securely Replaced: Reason For Pumping: El Other (see attached) C�'Yes ❑ No 2- es ❑ No 1 01,% r 'AA - Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, I.e., clacked tanks. missina baffles. broken mvers_ err. 7 rf cn_ aYnlaln in rnm mantic haImAl Tank #1 ❑ Yes o Tank #2 ❑ Yes 2rNo Pump Tank ❑ Yes o System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity EIMound ❑ 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: and Application: ❑ Wastewater Treatment Plant Disposal Site: Lime: Gallons 2 Plowed: ❑ Yes 3'No Time: ssI Temperature: l F°T pH: t Z_ z-Z > 12 ET — Time: (02,1 Temperature: 00 pH: t 2- Z- > 12 Ef ../�`•�-ti �•�'rsue,,, ..1--"`" ,..�.`'�-�, �'''i`� .sue.