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HomeMy WebLinkAbout2811 Farview Lane - Septic Pumping ReportJim Eicher D Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 _ `? ,9 -) <­ Maintenance Inspection Form e .#L4286 Maintainer Nick Sam • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Pumpin^ �,, .. - , .. Name: Long Pi Address: C G l rJ Other R City/State/Zip: ,fin Total C( Payment Method: ❑ Check ❑ Cash ❑ Credit nk (check if present) Tank leaks below the designed operating depth Tank leaks above the designed operating depth Maintenance hole cover is damaged, cracked, unsecured, or appears to be structurally unsound Septic/holding Tank #1 Gall ❑ Yes No �:No ❑ YesEl Yes No Septic/holding Tank #2 Gallons: El Yes No El Yes No ❑Yes �No ❑ Wettment Tank Ga ❑Yes ❑ No ❑Yes ❑ No ❑ Yes ❑ No Pump Tank Gallons: El Yes No ❑Yes No ❑ Yes No How Accessed: aintenance Hole Scum/Sludge Measur Maintenance s Securely Replaced: Reason F r Pumping: ❑ Other (see attached) ❑ Yes No es ❑ No Did you identify operational issues or unsafe acked tanks, missing baffles, bra Al ❑ Yes No I Tank #2 ❑ Yes ❑ Structural integrity ❑ Risers leaking ❑ Baffles ❑ Non -domestic waste Disposal Site: Time: Time: ❑ Risers leaking ❑ Baffles ❑ Non -domestic waste s while assessing the sewage tanks in this s, etc.? ifso, explain in comments Pump Tank ❑ Yes CT"No ❑ Risers leaking ❑ Baffles ❑ Electrical issues ❑ Non -domestic waste ❑ Effluent Filter/screen Cleaned? ❑ Yes ❑ No Disposal: --❑ Land Application: ❑ Wastewater Treatment Plant Lime: Gallons Temperature: „ Tpmnarature: ❑ Elevated drainfield ❑ Pressure bed ❑ Trenches ❑ Ponding/Surfacing ❑ Other: Plowed: ❑ Yes --B-Nb pH: 1 2 . S > 12_171 pH: > 12 ❑ Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 neTF r-7- � Z_!r Maintenance Inspection Form MPCA Lic. #L4286 Maintainer 0 Jim Nick Sam • Phone: 763-497-2764 • Email: duanesepticCcenturylink.net INVOICE Pumping Fee: Name: R-,�c Address: `� 5 Long Pull Fee: Other Repairs: City/State/Zip: Total Cost of Se ry c 14AAy� �, Payment Method: ElCheck El Cash ❑ Credit i�- Tank leaks above the Maintenance hole cover is damaged, cracked, unsecured, or appears to be leaks below the Tank (check if p d operating depth designed operating depth structural) unsound Septic/holding Tank #1 ❑ Yes D11<0 ❑ Yes C No ❑ Yes No Gallons: l e,va E?'Septic/holding Tank #2 No ❑ Yes 0 No Gallons: ❑ Yes Z/No ❑ Yes ❑ Pretreatment Tank ❑Yes ElNo El Yes ❑ No ❑Yes ❑ No Gallons: Pump Tank El Yes 0 No El Yes El No ❑ Yes �o Gallons: 1.�� How Accessed: aintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: El Other (see attached) f Yes El No C�7'Yes ❑ No Did you identify any operational issues or unsafe conditions while assessing the sewage tanks In this system, i.e., r�rL 4 t—Lc miccin h,fflac hrnitan rnverc. etr.77fso. explain in comments -below. Tank #1 ❑ Yes o Tank #2 ❑ Yes ONo Pump Tank El Yes ZINo 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: L''I 5 � / c,.r�i � -� $ Y5 -2 Disposal: Ear` d Application: ❑ Wastewater Treatment Plant Disposal Site: C Lime: Gallons i 1 Plowed: ❑ Yes No Time: t_" 2 TemperaturpH: Z_ 3 > 12 � Time: ® 3 q Temperature: k `�. pH: t Z- 2, > 12 D-l' Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE 1 _— 7 )-l� Pumoinq Feej u Maintenance Inspection Form 7s, Lic. #L4286 Maintainer Nick Sam • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Name: Address: utner mepalrs: V�iyrJtd�efL1f' o 4&__ ku __6;�3Do� , Payment Method: ❑ Check ❑ Cash redit Total Cost of Ss 37(�'7 � 3C) 5­9T ?3ooa Maintenance hole cover is damaged, Tank (check ,nk leaks below the Tank leaks above the cracked, unsecured, or appears to be esigned operating depth designed operating depth structural) unsound tn'&ptic/holding Tank #1 ❑ No El Yes o Gallo El Yes �o ❑Yes Septic/holding Tank #2 ❑ Yes e No ❑ Yes !Flap ❑ Yes ❑� Gallons: ❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallon Pump Tank ❑ Yes 2 No ❑ Yes o ❑ Yes No Gallons: How Accessed: Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumpin e, b,-jl ❑ Other (see attached) ❑ Yes iffr No es ❑ No Did you identify any operational issues or unsafe conditions while assessing the sewage tanks In thissstem, i.e., Tank #1 ❑ Yes ZL.DK Tank #2 ❑ Yes No Pump Tank ❑Yes No System ❑ Structural integrity ElStructural 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: ❑ Wastewater Treatment Plant Dis osal Site: Lime: f Gallons = Plowed: El Yes D-No P Time: ; Temperature: pH: > 12 -❑. Time: Temperature: pH: > 12 ❑ a► • `. ..� �,�,� �✓_` �--.sue- -�'''..�. ,✓'-'�-,. �.�✓" .sue Jim Eicher Maintenance Inspection Form MPCA Lic. #L4286 Maintainer Jim k�Vick p o4 = Sam Septic Service, LLC • Phone: 763-497-2764 1205 LaBeaux Ave NE St. Michael, MN 55376 •Email: duaneseptic@centurylink.net DATE —7 - °i - Z INVOICE _ Pumping Fee: Name: `(' D�3 Long Pull Fee: Address: 3ky 51`Ak Ret' Other Repairs: City/State/Zip: Total Cost of SE Payment Method: heck ❑ Cash ❑ Credit Maintenance hole cover is damaged, Tank (check ink leaks below the ueb7gned operating depth Tank leaks above the cracked, unsecured, or appears to be designed operating depth structural) unsound IT-Septic/holding Tank #1 ❑ Yes I to ❑ Yes ❑ No 2--Ves ❑ No Gallons: Sx,97 Septic/holding Tank #2 El Yes C�"No El Yes E�No ❑Yes (n N0 Gallons: E-,��t Tank 44 3 ❑ Yes C3' No ❑ Yes ❑ No ❑ Yes Er No Gallons: t ❑ Pump Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: How Accessed: Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: ❑ Other (see attached) T C-1'Yes ❑ No Ds ❑ No Did you identify any operational issues or unsafe conditions while assessing the sewage tanks In this system, i.e., ai. '2 rFa ovniain in rnmments below. Tank #1 ❑ Yes No Tank #2 ❑ Yes o Pump Tank ❑ Yes ❑ No System ❑ Structural integrity ❑ Structural integrity ❑ Risers leaking ❑ Structural integrity ❑ Risers leaking Mound ❑ Elevated drainfield ❑ Risers leaking ❑ Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed ❑ Non -domestic waste ❑ Non -domestic waste ❑ Electrical issues ❑ Non -domestic waste ❑ Trenches ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑ Yes ❑ No Comments: t Si E'� !{ ; U i AL W C©vs/ bh Disposal: Disposal Site: Lime: Time: Time: ❑ Land Application: 2'Wastewater Treatment runt — Gallons 36-s'o w`� Plowed: ❑ Yes ❑ No Temperature: pH: > 12 ❑ Temperature: pH: > 12 ❑ Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE 7-L� Maintenance Inspecti n Form MP Lic. #L4286 Maintainer Jim Nick 0 Sam • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net /�10Lyle] Cr7:11 Pumping Fee: Name: ScC-i r�S Address: Long Pull Fee Other Repair City/State/Zip: C f v" Total Cost of S Payment Method: ❑ Check ❑ Cash ❑ Credit Ta ec ank leaks below the Tank leaks above the Maintenance hole cover is damaged, cracked, unsecured, or appears to be igned operating depth designed operating depth structural) unsound �Ilepticllholdinq Tank #1 Yes No El Yes � El Yes No Gallons: El eptic/holding�Tank #2 ❑Yes No ❑ Yes lo — El Yes No Gallons: 1 ❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallon ump Tank �❑ No Gallons: � j �% ❑ Yes No El Yes No El Yes How Accessed: 7Gaintenance Hole Scum/Sludge Measured Maintenannc,.e--Hoolle`s�Securely Replaced: Reason For Pumping: ❑ Other (see attached) ❑ Yes No eC��S' s ❑ Now Did you identify operational issues or unsafe conditions while assessing the sewage tanks In this system, f.e., acked tanks. missino baffles, broken co etc.? Ifso, explain in comments bell Tank #1 ❑ Yes No Tank #2 ❑ Yes o 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: ..10 Land Application: ❑ Wastewater Treatment Plant Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No Time: Temperature: pH: > 12 ❑ Time: Temperature: pH: > 12 ❑