HomeMy WebLinkAbout145 Turnham Road - Septic Pumping ReportDV�NE��
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE en-1"i1- ZJf
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer Jim
ick
Sam
® Phone: 763-497-2764
® Email: duanesepticCcenturylink.net
iMMUIP
Pumping Fee.
Name:
Long Pull Fee
Address:
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Other Repairs
City/State/Zip:
Total Cost of
ki
Payment Method: ❑ Check ❑ Cash ❑ Credit
Tank leaks above the
Maintenance hole cover is damaged,
s below the
Tank (chef
operating depth
designed operating depth
cracked, unsecured, or appears to be
structural) unsound
2'9eptic/holding Tank #1
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
D eptic/holding Tank #2
Gallons: --�-�a
El Yes
El No
El Yes El No
El Yes El No
❑ Pretreatment Tank
Gallons:
ElYes
❑ No
I]Yes ❑ No
ElYes I]No
❑ Pump Tank
Gallons:
❑ Yes
❑ No
❑ Yes ❑ No
❑ Yes ❑ No
How Accessed:
1 Mai. tenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
Other (see attached) ❑Yes El No ❑ Yes ❑ No Aje�5
t
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 ❑ No
Tank #2 ❑ Yes ❑ No
Pump Tank ❑ Yes ❑ No
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: ❑ Land Application: [?`Wastewater Treatment Plant t, ,q,4</ L✓�+
Disposal Site:
Lime:
Gallons /
Plowed: ❑ Yes ❑ No
Time:
Temperature:
pH: > 12 ❑
Time:
Temperature:
pH: > 12 ❑
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