HomeMy WebLinkAboutSeptic Pumping 9.30.24Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE 5-30-Z
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer 0 Jim
Nick
Sam
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
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Pumping Fee:
Name:
Long Pull Fee:
Address: c�
SN-e 0
J +�S S-Z
1C UV_
Other Repairs:
\
City/State/Zip:
o_o
Total Cost of Servi
(�
Payment Method: Check ❑ Cash
❑ Credit
t Vw
Tank check if resent
( 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
21"Septic/holding Tank #1
Gallons: I Z �
El Yes
M o
El Yes ❑ No
❑ Yes
Septic/holding Tank #2
Gallons: l Zip
❑Yes
oo
❑ Yes No
❑ Yes
_ffT'o
❑ Pretreatment Tank
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes
❑ No
Pump Tank
❑Yes
Z
Gallons: c�ts-t7
No
❑ Yes No
❑ Yes
e'No
How Accessed: Maintenance Hole
Scum/Slu e Measured
Maintenance Holes Securely Replaced:
Reason For Pumping:
❑ Other (see attached)
C3'Yes ❑ No
Cd'Yes ❑ No
111/1e�, t*�--
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cracked tanks, missing baffles, broke overs, etc.? Ifso, explain in comments ow.
Tank #1 ❑ Yes 0 No
Tank #2 ❑ Yes En No
Pump Tank ❑ Yes E3No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
2rMound
❑ 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: ffl"L�yd Application: ❑ Wastewater Treatment Plant
Disposal Site:
V1
I Lime:
Gallons ?
Plowed:
❑ Yes
ffrNo
Time:
qY Z
Temperature: t `.
pH:
1 2_2-
> 12 E�'
Time:
Temperature: (4,
pH:
1 Z - Z
> 12