HomeMy WebLinkAbout3415 Watertown Rd Orono Septic maintenance formEnde Septic Service, LLC, MPCA Lic #L2654
24910 Territorial Road • Rogers, MN 55374
Phone: 763-428 4489
email: info(a)endeseptic.com
Maintenance Inspection Form
❑ Tristan i@ Brandon ❑ Scott ❑ Kurt ❑ Robert
l� Maintenance ❑ Emergency ❑ Other 4 pop location: ❑ Land ap *Treatmenth plant
Date: ct"
Invoice
Name: A55 Zu -e'"
Description:
Address: 3 �� - Al Cfjes ✓n
Total Cost of Service:
City/State/Zip: no
Payment Method: ❑ Check ❑ Cash ❑ Credit
Tank (check if present)
Tank leaks below the
Tank leaks above the
Maintenance hole cover is
designed operating
designed operating
damaged, cracked,
depth
depth
unsecured to be
orally sound
1�Septic/holding Tank #1
❑ Yes of No
❑ Yes -IF No
❑ Yes t�No
Gallons: 116040 'S
Al Septic/holding Tank #2
❑ Yes No
❑ Yes No
❑ Yes No
Gallons:
❑ Pretreatment Tank
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Gallons:
lk Pump Tank
❑ Yes ONO
❑ Yes 6-No
❑ Yes A5No
Gallons:
Did you measur the accumulation of scum and sludge? aYes ❑ No
Access point: Cover/maintenance hole; if so, were covers secured in place? AYes ❑ No
Access point.-ErV spection pipe; if through pipe, did homeowner sign off
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cracked tanks, missing baffles, broken covers, etc.? If so, explain in comments below.
Tank #1 []Yes KNo
Tank #2 ❑ Yes A No
Pump Tank t Yes ❑ No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
❑ Mound
❑ Risers leaking
❑ Risers leaking
❑ Risers leaking
A Elevated drainfield
❑ Baffles
❑ Baffles
❑ Baffles
❑ Pressure bed
❑ Non -domestic waste
❑ Non -domestic waste
kElectrical issues
❑ Trenches
❑ Non -domestic waste
❑ Ponding/surfacing
❑ Effluent filter cleaned?
❑ Other:
[]Yes ❑ No
Comments: 1 /�/ t'�L s. ~ u /J S D� n5
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