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Ende Septic Service, LLC, MPCA Lic #L2654 <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 7634284489 <br />email: i_nfo(a,endeseptic.com <br />Maintenance ❑ Emergency ❑ Other <br />Maintenance Inspection Form <br />❑ Tristan Brandon ❑ Scott ❑ Zach ❑ Robert <br />Disposal location: ❑ Land ap )d Treatment plant <br />Date: ' l,v/it e7— <br />Invoice <br />Name: <br />rQ) <br />Description: <br />( W� <br />Address: <br />Un ( <br />Total Cost of Service: <br />City/State/Zip: <br />N <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />Tank (check if present) <br />Tank leaks below the <br />Tank leaks above the <br />Maintenance hole cover is <br />designed operating <br />designed operating <br />damaged, cracked, <br />depth <br />depth <br />unsecured, or appears to be <br />structurally sound <br />Septic/holdin Tao #1 <br />El1 Yes No <br />❑ Yes No <br />❑ Yes VNo <br />Gallons: <br />*eptic/holdin Tank #2 <br />❑ Yes �tN0 <br />❑ Yes I /No <br />El Yes SpNo <br />Gallons: <br />(_ <br />/ <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />Pump Tank <br />❑ Yes 4No <br />❑ Yes 9No <br />❑ Yes alfNo <br />Gallons: I b <br />I/ <br />Did you measure the accumulation of scum and sludge? A Yes ❑ No <br />Access point: a*nce hole; if so, were covers secured in place? Yes ❑ No <br />Access point: speQ 1— ction pipe; if through pipe, did homeowner sign off ? ❑ Yes ❑ No <br />Dad you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., <br />cracked tanks, missing baffles, broken covers, etc.? If so, explain in comments below. <br />Tank #1 ❑ Yes ii No <br />Tank #2 ❑ Yes No <br />Pump Tank ❑ Yes INo <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />T Mound <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Elevated drainfield <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />❑ Pressure bed <br />❑ Non -domestic waste <br />❑ Non -domestic waste <br />❑ Electrical issues <br />❑ Trenches <br />❑ Non -domestic waste <br />❑ Ponding/surfacing <br />❑ Effluent filter cleaned? <br />❑ Other: <br />❑ Yes ❑ No <br />Comments: <br />