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Maintenance Inspection Form <br />Ende Septic Service, LLC, MPCA. Lic #L2654 <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-428-4489 <br />email: infoO!endese>>tic. com <br />El Tristan 4'Brandon ❑ Scott ❑ Kurt ❑ Robert <br />_Maintenance ❑ Emergency ❑ Other Disposal location: ❑ Land ap -O-Treatment plant <br />Date: " " " <br />Invoice <br />Name: <br />Description <br />Address:' <br />Total Cost of Service, <br />City/State/Zip: '" < r 11• 7 <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />f'x <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 />LJ' Septic/holding Tank #1 <br />❑ Yes 2 No <br />❑ Yes No <br />❑ Yes No <br />Gallons: <br />P'Septic/holding Tank #2 <br />❑ Yes E,� No <br />❑ Yes ,y No <br />❑ Yes No <br />Gallons: a-" <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />,11 Pump Tank <br />❑ Yes Q_ No <br />❑ Yes S No <br />❑ Yes MNo <br />Gallons: <br />Did -you measure the accumulation of scum and sludge? l`Yes ❑ No <br />r,- <br />Access point: Cover/maintenance hole; if so, were covers secured in place? t Yes ❑ No <br />Access point" Mllispection pipe; if through pipe, did homeowner sign <br />Did 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 ❑ Yesj:Q No <br />Tank #2 ❑ Yes Q No <br />Pump Tank ❑ Yes b No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />] Mound <br />Er <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 />1 Yes ❑ No <br />Comments: <br />