HomeMy WebLinkAbout3745 Watertown Road - Septic Pumping ReportSeptic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE C q - 0 --( — Z 75
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer 0 Jim
Nick L
0 Sam
® Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
IIN1/r11rF
Pumping Fee: Z�C�
Name: //2
Long Pull Fee: �
Address:
Other Repairs:
City/State/Zip:
c
br_cw1-1 /\) I
Payment Method: ❑ Check ❑ Cash ❑ Credit
Total Cost of Service:
b
Tank leaks above the
Maintenance hole cover is damaged,
Tank (check if present)
e gn
designed operating depth
cracked, unsecured, or appears to be
structurally unsound
Septic/holding Tank #1
Gallons: ���
El Yes
I�o
^
❑ Yes E;r o
❑ Yes 0—no
Septic/ olding Tank #2
Gallons: 'I , 0`2
❑ Yes
[:�/N o
❑ Yes /940
ElYes No
❑ Pretreatment Tank
Gallons:
ElYes
ElNo
ElYes ❑ No
❑ Yes ❑ No
Pump Tank
❑
'b
❑
El No
Gallons: � � a
Yes
No
Yes No
Yes
How Accessed -.-.,^^aintenance Hole
Scum/Sludge Measured
Maintenance Holes Securely Replaced:
Reason For Pumping:
El Other (see attached)
El Yes No
—e Yes El No
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.? Ifso, explain in comments below.
Tank #1 ❑ Yes 9<o
Tank #2 ❑ Yes E�l�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: -e�a nd Application: ❑ Wastewater Treatment Plant
Disposal Site: 'J ``
Lime:
Gallons
Plowed: ❑ Yes --❑ No
Time:
Temperature:
pH: > 12 ❑
Time:
Temperature:
pH: ! <: > 12 0