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HomeMy WebLinkAbout1905 Heritage Drive - Septic Pumping ReportJim Eicher Maintenance Inspection Form MPC Lic. #L4286 Maintainer Jim Nick D 0 Sam Septic Service, LLC ® Phone: 763-497-2764 1205 LaBeaux Ave NE St. Michael, MN 55376 a Email: duaneseptic@centurylink.net DATE INVOICE Pumping Fee: Name: �, -(_ vl� c f V C ch Long Pull Fee: Address: Other Repairs: City/State/Zip:: Total Cost of Servic( Payment Method: ❑ Check Cash Credit ✓ the Tank leaks above the Maintenance hole cover is damaged, Tank (check if pre cracked, unsecured, or appears to be designed operating depth designed operating depth structural) unsound Septic/holdin Tank #1 Gallons: ZZ❑ Yes No ❑ Yes No ❑ Yes No ❑ Septic/holding Tank #2 ❑Yes ElNo ❑Yes ElNo El Yes ElNo Gallons: ❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallon . Pump Tank ❑ Yes ZN ❑ Yes 45<o ❑ Yes No Gallons: 16W How Accessed: Maintenance Hole ❑ Other (see attached) Scum/Sludge Measured T ❑ Yes o Mainte:an HH les Securely Replaced: ❑.k`�s ❑ Nc Reason For Pumping: i�4 Did you idenoperational issues or unsafe conditionshile assessing the sewage tanks in this system, i.e., rkarl ranks. missino haffles. broken ems, etc. ? If so, explain in comments_a01& D: 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: e Wastewater Treatment Plant Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No Time: Temperature: pH: > 12 ❑ Time: Temperature: pH: > 12 ❑ Jim Eicher Maintenance Inspection Form r DVANE� Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE' "7 - 2r MPCA Lic. #L4286 Maintainer 0 Jim 'Nick Sam • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Pumping F Name:�s5RA Long Pull I Address: Ll 2-co (2j Other Rep City/State/Zip: Total Cost � Payment Method: ❑ Check ❑ Cash ❑ Credit Tank leaks above the Maintenance hole cover is damaged, cracked, unsecured, or appears to be leaks below the Tank d operating depth designed operating depth structural) unsound eptic/holding Tank #1 ❑ Yes No ❑ Yes C-1q; ❑ Yes No Gallons: Septic/holding Tank #2 El Yes 16 No El Yes 171 No El Yes ❑ No Gallons: t00,0 ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 21"Pump Tank ❑Yes Colo Gallons: 3 El Yes �' No ❑Yes No How Accessed: Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: ❑ Other (see attached) 12 es ❑ No 2- es ❑ No Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., tracked tanks, missing baffles, broken covers, etc.? If so, explain in commentsbelow. Tank #1 ❑ Yes o Tank #2 ❑ Yes No Pump Tank ❑ Yes No 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: FrIand Application: ❑ Wastewater Treatment Plant Disposal Site: rye Z Lime: Gallons 2- t--) Plowed: ❑ Yes Time: ' t q Temperature: -?_ t pH: t Z-'L > 12 Time: q ql Temperature: 7 0 - -7 pH: t 2- Z > 12 E�' Jim Eicher Maintenance Inspection Form MPCA Lic. #L4286 D Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE '9- (C- L-f' Maintainer 0 Jim (Vick = Sam • Phone: 763-497-2764 • Email: duaneseptic9centurylink.net INVOICE Pumping Fee: Name: Address: 1 1 ©S l J v l Long Pull Fee: Other Repairs: City/State/Zip: Total Cost of Se A" Payment Method: ❑ Che-1, ❑ Cash Credit �a ¢ -71. Q o Tank leaks above t Maintenance hole ver is damaged, elow the Tank (check i ausignen ting depth designed operating dep cracked, unsecu d, or appears to be stru rall unsound Fer'S'eptic/holding Tank #1 Gallons: Z5� ❑Yes El No El Yes El No El Yes ElNo ❑ Septic/holding Tank #2 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: EI-Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: -1T4 G� 'Pll�ump Tank Gallons: to-&o ❑ Yes ❑ No El Yes ❑ No ❑Yes ❑ No How Accessed: ❑ Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: El Other (see attached) ❑ Yes El No ❑ Yes El No i- -4 �c� 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: ErW--astewater Treatment Plant l.-4--o—"�_ Disposal Site: Lime: Gallons _ -3 Plowed: ❑ Yes ❑ No Time: Temperature: pH: > 12 ❑ Time: Temperature: pH: > 12 ❑ - -it onz,���-� Vim, �,✓`r �..�� ,.,�+'"`�. ,�..�ti ,�./ 1"._041- N Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 neTF� Maintenance Inspection Form ;MPCA ic. #L4286 Maintainer m Nick 0 Sam • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Pumping Fee: Name:< Address: r Long Pull Fee: 0C r Other Repairs: City/State/Zip: C) rvet D Total Cost of Sere Payment Method: ❑ Check ❑ Cash ❑ Credit flow the Tank leaks above the Maintenance hole cover is damaged, Tank (check if ing depth designed operating depth cracked, unsecured, or appears to be structural) unsound Septic/holding Tank #1 1ii1 �� I--] Yes z;VNo [I Yes � El Yes No Gallons: Septic/holding Tank #2 01,0 ❑ Yes C�No ❑ Yes E,;L_N,9 ❑ Yes Gallons: t ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No �mp Tank /� Gallons: 69 ❑ Yes �No El Yes ❑ Pdo El Yes -� No How Accessed:aintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: El Other (see attached) ' El Yes 2 o ❑-'re ❑ No (L' Did you identify �y operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., rarkarl tankc_ missinn hafFla.s_ hrnken rov€rs, etc.? If so, explain in comments below. Tank #1 ❑ Yes FANo 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: ❑ Land Application: 2rWastewater Treatment Plant Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No Time: Temperature: pH: > 12 ❑ Time: Temperature: pH: > 12 ❑ �.�•�� Vim`. �•�,,r�-�--�� .�"`r �..��, ,�✓'� �"s�- Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE 9-- c'N Z-r Maintenance Inspection Form MPCA Lic. #L4286 Maintainer 0 Jim Nick 0 Sam • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Pumping Fee. Name: Address: 3 ti /� ± I Long Pull Fee: Other Repairs: City/State/Zip: Lov, , Lk .P Qr Total Cost of S Payment Method: ❑ Check ❑ Cash ❑ Credit Tank leaks above the Maintenance hole cover is damaged, low the Tank (che ing depth designed operating depth cracked, unsecured, or appears to be structural) unsound tic/holding Tank #1 Gallons: to -a El Yes grlQo ❑Yes C3—roo El Yes �eptic/holding Tank #2 Yes Gallons: s—a-o ❑ Yes Z No ❑ Yes E-_ ❑ 2_1�0 ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑-Kmp Tank �) / ❑Yes No Gallons �v El Yes No El Yes No How Accessed: Maintenance Hole Scum/SSl ge Measured Maintenance Holes Securely Replaced: Reason For Pumping: El Other (see attached) CJ Yes ❑ No ( ❑ No Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., -cracked tanks. missino baffles, broken covers, etc.? If so, explain in comments below. Tank #1 ❑ Yes No Tank #2 ❑ Yes ElNo 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: ❑ Land Application: Wastewater Treatment Plant Disposal Site: Lime: Gallons 2!,*_0 Plowed: ❑ Yes ❑ No Time: Temperature: pH: > 12 ❑ Time: Temperature: pH: > 12 0 r Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN55376 nATF 9.1j -.1 Maintenance Inspection Form MPCA Lic. #L4286 Maintainer Jim 0 Nick 0 Sam • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Pumping Fee: Name: j I I e Address: r-- T Long Pull Fee: City/State/Zip: Other Repairs: C �J✓�� Total Cost of SE Payment Method: ❑ Check ❑ Cash ❑ Credit below the Tank leaks above the Maintenance hole cover is damaged, Tank (checl rating depth designed operating depth cracked, unsecured, or appears to be structural) unsound Septic/holding Tank #1 I -L5D El Yes No ❑Yes No ❑Yes Gallons: ❑ Septic/holding Tank #2 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: ❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: dump Tank ElYes Z% No ❑ Yes lo/ Gallons: %010 ElYes No How Accessed: Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason Pumping: El Other (see attached) ❑ Yes -1 No DYe—s� ❑ No lFpr I 1 r 1 Did you identl _,,'ny operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., ccracked tanks, missing baffles, broken covers etc. ? If so, explain in comments Frelow. Tank #1 ❑ Yes CT No Tank #2 ❑ Yes o 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 Disposal Site: ``' _ Lime: Gallons Plowed: ElYes ❑ No Time: �� Temperature: pH: Time: 9 S Temperature: ; ; pH: I < , < > 12 ❑ Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN p55376 DATE Q- Z !� Maintenance Inspection Form MP Lic. #L4286 Maintainer Jim Nick 0 Sam • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Pumping Fee: Name: 1l j M Long Pull Fee: Address: 305-0 n 1�— Other Repairs: City/State/Zip: () ra Payment Method: ❑ Check ❑ Cash CkCredit Total Cost of ServicE the Tank leaks above the Maintenance hole cover is damaged, Tan eck if pre gne opera ing depth designed operating depth cracked, unsecured, or appears to be structural) unsound Septic/ oldi Tank #1 ❑ Yes eNo ❑ Yes ❑�o ❑ Yes elTo Gallons: -op peptic/holding Tank #2 El Yes , C3�No El Yes El Yes No Gallons: j� ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No imp Tank eo ❑ Gallons: ❑ Yes E, " ❑ Yes .;;41 Yes o How Accessed: IIAfaintenance Hole Scum/Sludge Measued �� Maintenance Holes Securely Replaced: Reason F Pumping: El Other (see attached) ❑ Yes ;�No -1�11es ❑ No Did you identify a" operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., racked tanks, missing baffles, broken c etc.? If so, explain in comments_aei6-w— Tank #1 ❑ Yes WrNo Tank #2 ❑ Yes No Pump Tank ❑ Yes DTlqo 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: &'wastewater Treatment Plant Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No Time: Temperature: pH: > 12 ❑ Time: Temperature: pH: > 12 ❑ ,✓�-�-�. �`'� sue. ,.�- �`'� .s�- Jim Eicher Maintenance Inspection Form MPCA Lic. #L4286 Maintainer Jim ick D Sam Septic Service, LLC 1205 LaBeaux Ave NE •Phone: 763-497-2764 St. Michael, MN 55376 • Email: duaneseptic@centurylink.net DATE �Y `� zS INVOICE Pun Name: 5Cla v1 Lon Address: U Oth City/State/Zip: o -�i 3 3 61ro V�'o T t� �,� Payment Method: ❑ Check ElCash ElCredit ck Maintenance hole cover is damaged, Tank leaks below the Tank leaks above the designed operating depth designed operating depth cracked, unsecured, or appears to be stru turally unsound Septic/holding Tank #1 Gallons: I$_ ❑Yes ❑ No [I Yes ❑ El Yes Colo 21'Septic/holding Tank #2 ❑ Yes 01<0 ❑ Yes El Yes .e No Gallons: � ��� ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ump Tank Gallons: ❑Yes No El Yes No ❑Yes No How Accessed: El Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: i ❑ Other (see attached) Yes ❑ No ©'Yes ❑ No ftlk I ``l°'� Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., ,,�r'acked tanks, missinq baffles, broken t6vers, etc.? if so, explain in comments below. Tank #1 ❑ Yes DrNo Tank #2 ❑ Yes o Pump Tank ❑ Yes ONo System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity ff 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: )Aland Application: ,'wastewater Treatment Plant Disposal Site: Lime: Gallons .Z l 6-4 Plowed: ❑ Yes ❑ No Time: Temperature: pH: > 12 ❑ Time: Temperature: pH: > 12 ❑ '�.�.t �ir .i'� ��i�•/ •� ���; '_� .•�.t fir �'� �r�/ � ,✓�-� ,� .sue. --.�' ,�,�.-'�-�, �`',� �t�,,