HomeMy WebLinkAbout1320 Orono Oaks Drive - Septic Pumping ReportSeptic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE r 2 "% 2
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer = Jim
1'Nick
= Sam
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
Pumping Fee:
Name:
INVUlUE
Long Pull Fee:
Address:
zo eof
�c�✓ rti
Other Repairs:
City/State/Zip:
Total Cost of Servic
\ �/
Payment Method: ❑ Check ❑ Cash ❑ Credit
� aH
Tank leaks above the
Maintenance hole cover is damaged,
Tank (check if iks below the
operating depth
designed operating depth
cracked, unsecured, or appears to be
structural) unsound
Septic/holding Tank #1
Gallons: ( D00
❑ Yes C- No
❑ Yes ET-N—o
❑ Yes
C�Septic/holding Tank #2
Gallons: ovo
❑ Yes d No
❑ Yes 2r1N'_o
❑ Yes 2_1go
❑ Pretreatment Tank
Gallons:
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
CYfump Tank
�
El Yes ®'No
❑ Yes
Gallons: ��,�
No
❑ Yes 171No
How Accessed: El Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping:
ElZ Other (see attached) Yes ❑ No I CYYes ❑ No 1 M4 , ,
Did you identify any operational issues or unsare conditions while assessing the sewage tanks in this system, i.e.,
cracked tankc- miccinn hafni h-1— � .a arm 7 ra � .,.,,_:_ _ ,.
Tank #1 ❑ Yes No
Tank #2 ❑ Yes No
Pump Tank ❑ Yes No
System
❑ Structural integrity
❑ Structural integrity
❑ Structural integrity
RrMound
❑ 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
Cl Ponding/Surfacing
❑ Effluent Filter/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
Comments:
Disposal: C"Larid Application: ❑ Wastewater Treatment Plant
Disposal Site: l
Lime:
Gallons 2 wo
Plowed:
❑ Yes o
Time: j 1 D 1
Temperature:
I L/
pH:
( 2- 3 > 12
Time: 1 f 5" 7
Temperature:
I r U
pH:
+ Z > 12
Jim Eicher
RI
D °
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE Dc 'Z7Z
Pumping FeeVN
:,
Lono Pull Fee:
rs:
Total Cost of S
Tank (check if present)
Septic/holding Tank #1
Gallons: S D
eptic/holding Tank #2
Gallons: Soo
❑ Pretreatment Tank
Gallons:
ump Tank
Gallons: Sryc)
aintenance Hole
❑ Other (see attached)
Did you identifY3 o
❑ Risers leaking
❑ Baffles
❑ Non -domestic waste
Tank leaks below the
designed operating depth
❑ Yes No
❑ Yes u ivo
❑ Yes ❑ No
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer = Jim
0 Ni c
Sam
• Phone: 763-497-2764
• Email: duaneseptic9centurylink.net
ame: `l �wGL J
ddress:
D(-,g V)v
Payment Method: ❑ Check
Tank leaks above the
designed operating depth
ElYes 0/<
❑ Yes ❑' No
Yes ❑ No
Cash ❑ Credit
Maintenance hole cover is damaged,
cracked, unsecured, or appears to be
structurally unso_u id
❑ Yes
❑ Yes No
❑ Yes ❑ No
No
I
❑ Yes � I
❑ Yes � ivu
El Yes
Scum/Sludge Measured
intenance ecurely Replaced:
Reason For Pumping.
❑ Yes No
❑ es ❑ No
or unsafe conditions w i essing the sewage tanks in this
w•
m, i.e.,
perational issues
tanks, missing baffles, broken co
etc.? If so, explain in comments
o System
ik #2 ❑ Yes o
Pump Tank ❑Yes
ound
❑ Structural integrity
❑ Structural integrity
❑Risers leaking
[I Elevated drainfield
❑ Risers leaking
❑ Baffles
❑ Pressure bed
[I Baffles
El Non -domestic waste
❑ Electrical issues
❑ Non -domestic waste
❑ Trenches
❑ Ponding/Surfacing
❑ Effluent Filter/screen
❑ Other:
Cleaned? ❑ Yes ❑ No
❑ Land A lication: CiWastewater Treatment
Disposal: pp
Lime: Gallons
Disposal Site: Temperature:
Time: Temperature:
Time:
G THANKS!
riT
0
Plowed: ❑ Yes ❑ No
pH: > 12 ❑
pH: > 12 ❑
Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE (�C-3v•—%�
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer 0 Jim
0 Nic
Sam
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
Pumping Fee:
Long Pull Fee:
Other Repairs:
Name: �f r
I ay
IIY Y VI</G
Address:
130b J)ror,�6 �,kS
pr,
City/State/Zip:
(pro V16
Total Cost of Sery
Payment Method: ❑ Check
❑ Cash
❑ Credit
Tank (check if present)
Tank leaks below the
designed operating depth
Tank leaks above the
designed operating depth
Maintenance hole cover is damaged,
, crackedunsecured, or appears to be
structurally unsound
Septic/holding Tank #1
Gallons: Zb
❑ Yes No
ElYes o
❑ Yes
/
2—NO
ff-Septic/holding Tank #2
Gallons: 5Dd
❑ Yes 'CoET
❑ Yes o
❑ Yes
No
❑ Pretreatment Tank
Gallons:
LQ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
Pump Tank
Gallons: Svv
❑Yes o
❑ Yes o
❑ Yes
o
How Accessed: ErMaintenance Hole Scum/Sludge Measured aint7_��
ecurely Replaced: Reason For Pumping:
❑ Other (see attached) ❑ Yes No ❑ No
Didyou identify an ational issues or unsafe conditions w ssessing the sewage tanks in this i.e.,
ed tanks. missino baffles. bmkan rn etc 7 Tf cn. aYnlain in rnm-f•c h
Tank #1 ❑ Yes ZrNo
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: __'J�fwastewater Treatment Plant ' (,)
Disposal Site:
Lime:
Gallons
Plowed: ❑ Yes ❑ No
Time:
Temperature:
pH: > 12 ❑
Time:
Temperature:
pH: > 12 ❑
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