HomeMy WebLinkAbout770 Lakeview Parkway - Septic Pumping Report (221)II-�I Ei �it�
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
®ATIE J-2S-7i
�on ea nc- Inspection Form
Maintainer Jim
(Vick
�= Sam
Phone: 763-497-2764
Email: duaneseptic9centurylink.net
Pumping Fee:
Name:
lI�iVUtt;�
i.
Long Pull Fee:
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_
Address:
Other Repairs:
Z f�
City/State/Zip:
U 0
Total Cost of Service:
COur t=
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Payment Method:
❑ Check
❑ Cash
❑ Credit
Tank (check if present)
Tank leaks below the
Tank leaks above
the
Maintenance hole
cover is damaged,
designed
operating depth
designed operating
depth
cracked, unsecured,
or appears to be
structurally
unsound
❑ Septic/holding Tank #1
Gallons: 10
❑ Yes
❑
No
❑ Yes
❑
No
❑ Yes
❑ No
❑ Septic/holding Tank #2
Gallons: ! .; <,
❑ Yes
El
No
❑ Yes
❑
"No
❑ Yes
❑ "No
❑ Pretreatment Tank
Gallons:
❑ Yes
❑
No
❑ Yes
❑
No
❑ Yes
❑ No
❑ Pump Tank
Gallons: 1 ` S =
❑ Yes
❑
No
❑ Yes
0
'No
❑ Yes
❑- No
How Accessed: ❑Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
❑ Other (see attached) ❑ Yes ❑ No ❑"Yes ❑ No !!ln lcn -
Did
you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
cracked tanks. missino baffles. hmkan rn varc orr rf ov imrn in
Tank #1
❑Yes ❑'No
Tank #2 El Yes ❑ No
Pump Tank El 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: El Wastewater Treatment Plant
Disposal Site: Lime: Gallons Plowed: ❑Yes ❑ No
Time: Temperature: pH: > 12 Li
Time: Temperature: pH: > 12 0