HomeMy WebLinkAbout1920 Shoreline Drive - Septic Pumping ReportSeptic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE 9" Z -3 - ?-.!,'
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer = Jim
"Nick
= Sam
® Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
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Pumping Fee:
Name:
I /
Long Pull Fee:
t
Address: 1 2c>
i
Other Repairs:
City/State/Zip:
Total Cost of S
Payment Method:
❑ Check ❑ Cash ❑ Credit
Tank leaks above the
Maintenance hole cover is damaged,
Tank chec 3 below the
--"erating depth
designed operating
depth
cracked, unsecured, or appears to be
structurally unsound
eptic/holding Tank #1
Gall -
❑ Yes _R1,_No�
❑ Yes
loj_fQo
❑ Yes _;oi�o
s: Lmr,
Septic/holding Tank #2
El Yes CST No
Gallons: ,�-�%
❑ Yes
la o
❑ Yes ❑'No
❑ Pretreatment Tank
Gallons:
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes ❑ No
CKump Tank
El Yes (7'No
El
Gallons: Ly.�-0
Yes
No
ElNo
Yes
How Accessed: ❑` aintenance Hole
Scum/SSl dge Measured
Maintenance Holes Securely Replaced:
Reason For Pumping:
❑ Other (see attached)
J
?Yes El No
54es ❑ No
*
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cracked tanks, missing baffles, brokeaxovers, etc.? If so, explain in comments below.
Tank #1 ❑ Yes o
Tank #2 ❑ Yes 2No
Pump Tank ❑ Yes o
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
ound
❑ 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: C?'g/astewater Treatment Plant L.-,z4-c,40G- 0
Disposal Site:
Lime:
Gallons 2 3 -A-�2
Plowed: ❑ Yes ❑ No
Time:
Temperature:
pH: > 12 ❑
Time:
Temperature:
pH: > 12 ❑
P W.NOV
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