HomeMy WebLinkAbout2240 Abingdon Way - Septic Pumping Report - 2025Septic Service, LLC
1205 LaBeaux Ave NE
St. Michael, MN 55376
DATE
Maintenance Inspection Form
MPCA Lic. #L4286
Maintainer 0 Jim
*Nick
0 Sam
• Phone: 763-497-2764
• Email: duaneseptic@centurylink.net
INVOICE
Pumping F
Name:
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Long Pull F
Address: •Z 2 / �
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Other Rep;
City/State/Zip:
Total Cost
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Payment Method: ❑ Check ❑ Cash
❑ Credit
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Tank leaks above the
Maintenance hole cover is damaged,
cracked, unsecured, or appears to be
Tank (check if present)
Tank leaks below the
designed operating depth
designed operating depth
structural) unsound
❑ ptic/holding Tank #1
[I Yes Cyr
❑ Yes YIN o
El Yes
No
allons: Zoo
Septic/holding Tank #2
�
El Yes ] Vo
❑Yes ClNo
El Yes
f� No
Gallons: ( S'
❑ Pretreatment Tank
Gallons:
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
ffi/Pump Tank
❑ Yes j�7' No
I] Yes No
El Yes
�o
Gallons: (Z ��
How Accessed: aintenance Hole
Scum/Sludge Measured
Maintenance Holes Securely Replaced:
Reason For Pumping:
❑ Other (see attached)
CYYes ❑ No
el'es ❑ No
Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e.,
ci;acked tanks, missing baffles, brokenyavers, etc.? If so, explain in commen'>,below.
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: ❑ Land Application: 2'fg/astewater Treatment Plant L.,� Ic✓-I41"'
Disposal Site:
Lime:
Gallons Z&,c
Plowed: ❑ Yes ❑ No
Time:
Temperature:
pH: > 12 ❑
Time:
Temperature:
pH: > 12 ❑