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HomeMy WebLinkAbout200 Hollander Road - Septic Pumping ReportJim Eicher o Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 Maintenance Inspection Form MPCA Lic. #L4286 Maintainer Cal Jim L!J Nick C = Sam Phone: 763-497-2764 ® Email: duaneseptic@centurylink.net INVOICE N M I G ./ / r Pumping Fee: Long Pull Fee: Name: Address: Other Repairs: City/State/Zip: Z) Total Cost of Service: Payment Method: ❑ Check ❑ Cash ❑ Credit Tank (check if present) — the designed operating depth Tank leaks above the designed operating d/e+pth Maintenance hole cover is damaged, cracked, unsecured, or appears to be structural) unsound1 Septic/holding Tank #1 Gallons: { ' 5 u El Yes ©No El Yes C�( No ❑ Yes ; unNo eptic/holding Tank #2 Gallons: { p OD ❑ Yes No ❑ Yes Z—No ❑ Yes C�No ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No t Pump Tank Gallons: "-`Z) U ❑ Yes �o ❑ Yes t�o ❑ Yes /JN0 -low Accessed:EZf Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: ❑ Other (see attached) ❑ Yes Nos ❑ No r✓ ti--�r Did you Identify any operational Issues or unsafe conditions while assessing the sewage tanks in this system, l.e., x...."..,-. ,. .,f. rF o —Inin in rnmmantc helnw. Tank #1 El Yes No Tank #2 ❑Yes No Pump Tank El o System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity s 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: nisnosal: 6 Land Application: ❑ Wastewater Treatment Nlant Disposal Site: _/14 L. Lime: "i Gallons Plowed: ❑ Yes -❑,No rime: i I ' tx� Temperature: ( I pH: I ;; > 12 ❑ rime: t I ', Temperature: I.< <. pH: i" ' ', > 12 ❑ a, �•�:.�- ,�`'✓" .sue.. -�-^� ,�.-'�-.. ,� s� owl ❑ ZL < :Hd :aanleaadwa_L :aw11 ❑ Zl < :Hd :aanleaedwe_L :awll ON ❑ saA ❑ :pannolci cam,^ R suo11e0 :awrl :911S lesods14 tl,p-} lUeld luawleaal aalenn191SBAA-p :uolleollddy puej ❑ :lesodsl4 :sluawwo0 ON ❑ sal. ❑ 0eue010 ;aayl0 ❑ umospolll,j luan1113 ❑ 6uloelinS/6ulpuod ❑ BMW ollsewop-uoN ❑ seyouaal ❑ senssl Ie31a10013 ❑ alsem ollsawop-uoN ❑ elsenn opsawop-uoN ❑ paq oinssaad ❑ salllee ❑ 9a111e9 ❑ s011lE9 ❑ plolluleap POIBA013 ❑ 6uhleal saasld ❑ 6uhleal slasld ❑ 6uhleal sJosld ❑ punon,I Aipbolul leanlonalS ❑ Alla6alul leanlonals ❑ A1116alul lzmlonals ❑ welsAS ON-0 saA ❑ duel dwnd ONZ saA ❑ Z# duel ONZ saA ❑ l# v!Lij -molaq-sauawwoo u/ u/eloxe 'os jl Z'oaa 'sJanoa ua)iojq •s&yjeq oulssiuj -s4ue4 pdj.Ju.JJ ''a y 'WaWs s/qa u/ 54ue4 aBeMas aya bulssasse alp4m suop/puoo ajesun jo sanss/ Ieuopeaado Aue Ajpuap/ nolf plo ON ❑ saJ� f� ON ❑ sal, p (payoellie aes) aayl0 ❑ :6uldwnd and uose@H :paoeldalj �(laanoas sa1oH eoueualuleNl paanseaIN e6p�SS//wnog aloes aouauelulew passaooy nnoH o saA ❑ ON a Salk ❑ / 4N saA ❑ :suolloo � ue_L dwn0,Ej ON ❑ 60A ❑ ON ❑ saA ❑ ON ❑ saA ❑ :suolleCJ NueL luawleaalaad ❑ �. saA ❑ ON saA ❑ oN E saA El :suollEJ Z# Nue_L 6ulploy/olldaS ON saA ❑ saA ❑ o ® saA ❑ C3 �) :suolleJ G# Nue_L 6ulplou/ollda) punosun Alluinjonjis aq of sieadde ao 'painoesun 'pay oejo yldep 6ugeaado pau6lsep yldep 6upeaed"aLj6=e--- — — — A 11 Noep) duel o e 'pa6eweo si Janoloy aoueuelutelnl ayl anoge steel duel eyl Moleq s�{ llp()jo,,o qseOoa :p041M luawAed %1 � 1 :a aS 10 lsoo plol 4l� C ,A Aiz/olulS/A110 _ :saledeU ieyl0 :aad Ilnd Ouo-1 , o� GUI :ssaapp`d Za :ew>?N :eed 6uldwnd 3010ANI lau-� ullAAnluao�u)oildesau,enp :l!ew3 . V9L3-L6-V-E9L :au0gd Wes VIN wi - aaulejulen 983t,-1# 'Dl1voc1N mio3 uopedsul aaueualuieW vi L _ CZ _S :3-Lv u 9L699 NW 'I8e40I1M 'IS 3N any xneegel 90z l 0�-j `801MaS aijdaS Jim Eicher Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE S ' 2 l— Z. Maintenance Inspection Form MPCA Lic. #L4286 Maintainer = Jim 'Nick = Sam 4 Phone: 763-497-2764 ® Email: duaneseptic@centurylink.net INVOICE Pumping Fee: a Name: Y1✓1� i `ti 1 Long Pull Fee: Address: Other Repairs: City/State/Zip: Total Cost of Service: ��ti� ( Payment Method: ❑ Check ❑ Cash ❑ Credit r� G " Tank leaks above the Maintenance hole cover is damaged, eaks below the Tank (check if present ,uned operating depth designed operating depth cracked, unsecured, or appears to be structurally unsound O''eptic/holding Tank #1 El Yes C Jo ❑ Yes o ❑Yes ❑ No Gallons: - holding Tank #2 ❑ Yes GYNo ❑ Yes Cd'"No ❑ Yes ❑ No Gallons: Gallons; "`7� ❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: ❑ Pump Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: How Acessed: ❑Mai tenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: Other (see attached) Ell-re's ❑ No L7 Yes ❑ No Did you Identify any operational Issues or unsafe conditions while assessing the sewage tanks In this system, i.e,, -aracked tanks, missing baffles, broken�eovers, etc.? If so, explain In comments below. Tank #1 ❑ Yes o Tank #2 ❑ Yes No Pump Tank ❑ Yes ❑ No System ❑ Structural integrity ❑ Structural Integrity ❑ Structural Integrity ❑ Mound ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfieid ❑ Baffles ❑ Baffles ❑ Baffles ❑ �PPe� sure bed ❑ Non -domestic waste ❑ Non -domestic waste ❑ Electrical Issues C renches ❑ Non -domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other; Cleaned? ❑ Yes ❑ No Comments; Disposal: ❑ Land Application: P46stewater Treatment Plant Disposal Site: Lime: Gallons Plowed: ❑ Yes ❑ No Time: Temperature: pH: > 12 ❑ Time: Temperature: pH: > 12 ❑ D'i RR �,�� air ��s�--�--�� ,.1-�.—�,, �.�� �`,✓... ,,`"�� FIZZ . U�g ❑ Zl < :Hd :aanjwadwal :ew11 ❑ ZI < :Hd :aanjwgdwal :awll ON ❑ SPA ❑ :pannold suolJeJ :aw1j :aJ!S lesodsla) JUeld JuawJeaal JOIPMalsWE :uolleoliddy pue-1 ❑ :lesodsla :s;uawwo0 ON ❑ sal ❑ LPauealD :10410 ❑ umospollld luanUl3 ❑ 6u1ogjnS/6u1puod ❑ alseM ollsawop-uoN ❑ sayouaal ❑ sonssl peolaloa13 ❑ alseM oplsawop-uoN ❑ alseM ollsawop-uoN ❑ paq ainssaad ❑ s9111e8 ❑ selJlug ❑ salllue ❑ P191JuJeap p91ena13 ❑ 6upNeal saasl» ❑ 6ullleal saasll:l ❑ 6uNB81 saesld ❑ puno&Aoxj Alp Galul peanlonalS ❑ Alp5olul lemlon)IS ❑ AlpooluJ leanlonalS ❑ walsAS ower saA ❑ duel dwnd oNo sa k ❑ Z# dual oN salk ❑ #duel •Molaq sluawwoo u! uleldxa 'os jl Z •ola 'saalloo ua>loaq 'sal4eq 6ulssiw 1s>1ue4 pxparr '•a•1 'wals.(s slga ul pluq a6emas aqa 6ulssasse allgm suoplpuoo a/esun ao sanssl leuolle-lado 1tue Xjlauapl nolf pip ?l-4 I/ J r_7 5 ON ❑ —3N--ff) SGA ❑ (payoelle aas) aayl0 ❑ :6uldwnd and uosead :peoeldad /(laanoaS saloH aoueualulalN paansealnl abpnlS/wnoS aloes aouaualulalN, :passaooy MoH qAl--tr salk ❑ off. saA ❑ of sak ❑ :suolleJ i ual dwnd,,F,,� ON ❑ sal. ❑ ON LJ sGA ❑ ON ❑ saA ❑ ;suolleJ �uel Juawlaaalaad ❑ I--. ON—E-1 sal. ❑ , 9N—n sal ❑ —2y-19,saA ❑ :Suoijeo ue nfi l ' o oiJd@S1p Z# �I 1 PI 4/ Sl7 ,q sad ❑ o� ,L sal ❑ oN.l� sad ❑ CBuiplo :ijdaS J l# >lual 6ulPlou/o!JdaS punosun Alivinjonils a of smadda jo ' amoasun ' a oe�o q P P �f yidep 6uJleaado peu6lsep yldap 6upleaodo pau6 -- lJ �oayo) dual p06ewep sJ Janoo aloy aoueualuJUN ayl anoge s� eap dual ayl Molaq spot � i 2oS1jO }soo lelol �. l!PaaO ❑ IISL3 ❑ No84o ❑ :Po4jeW luewAed 0uCli 0 :d! :sAedeH i@gjo ' /tf \47F, I! tiqa `� 4{ ,l :ssaaZ/elelS/Al!o PPd ` :ead !Ind Ouoj f :aweN _ _ :aad 6uJdwnd :IJIV/\IVI Y � 31b'a J lau'� u!!Aanjuaugo!ldeseuenp :l!ew3 . 9L699 NW '1eeue1W 'IS t,9L3-L6t,-S9L :tuoyd o EIN any xnuege-1 90z � Oil `901MOS oildeS Wes a �31N O 98Zt7`I# '3! dodW C wjo-q u®ilaadsul aaueuajuseW aay313 uair Jim Eicher Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 DATE , - / / c-, Pumping Fee: y I — Other Repairs: Total Cost of Servi, Maintenance Inspection Form MPCA Lic. #L4286 Maintainer = Jim [Pick F-1 Sam o Phone: 763-497-2764 ® Email: duaneseptic@centurylink.net INVOICE ,vun w. Address: _> 3) City/State/Zip: --; I Payment meinou: C�"w FJ f'f 0 ❑ Check ❑ Cash ❑ Credit Maintenance hole cover is damaged, .I aks below the Tank leaks above the cracked, unsecured, or appears to be Tank (check it p oo,y,,ed operating depth designed operating depth structurally unsound ❑ Septic/holding Tank #1 ❑ Yes ❑­ NIo ❑ Yes ❑= No ❑ Yes El -No Gallons: ;' S eSeptic/holding Tank #2 ❑ Yes ❑' No ❑ Yes O%No ❑ Yes ❑...No Gallons: () ❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: ❑'Pump Tank ❑ Yes ©'fVo ❑ Yes 0'14o ❑ Yes [A -No Gallons: How Accessed: EI,Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: ❑ Other (see attached) E]-Yes ❑ No p Yes ❑ No A i Did you Identify any operational Issues or unsafe conditions while assessing the sewage tanks In this system, i.e., _,.1,,,., ar, 9 rr — avnlaln in comments below. Tank #1 ❑ Yes 0 No Tank #2 ❑ Yes Ell' N0 Pump Tank ❑ Yes 0-No System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity ❑Mound ❑ Elevated drainfield ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Pressure bed ❑ Baffles ❑ Non -domestic waste ❑ Baffles ❑ Non -domestic waste ❑ Baffles ❑ Electrical Issues ❑ Trenches ❑ Non -domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑ Yes ❑ No Comments: Disposal: Disposal Site: Lime: Time: Time: ❑ Land Application: Li -Wastewater I reatment rlant �U ek Kf l ' 1-' r Gallons Plowed: ❑ Yes ❑ No Temperature: pH: > 12 ❑ Temperature: pH: > 12 ❑ n G� a -T 1 :Hd "A I:ainleaadwal g sc :ewll Zl < �+ .Z J :Hd :aanleaadwal 2 :awll 0" SO), ❑ :peMold C' 02 A suolle0 :awl 1 :allS lesodsld lueld luawle -L JeleMalsW ❑ :uolleollociy puer :lesooslp :sluawwo0 ON ❑ SOA,2 Zpeue910 :aa41O ❑ uni.o iallld luan111 6ulovpnS/6ulpuod ❑ alsum ollsawop-u ❑ sagouaal ❑ senssl IeolaloO13 ❑ elseM ollsawop-uON ❑ alseM ollsawop-uON ❑ paq oinssaad ❑ sai11E9 ❑ sailleg ❑ seilluo ❑ Plolluleap PGIUA013 ❑ 6ulNaa1 saasld ❑ BUINE91 saasid ❑ 6ulNe01 siaslu ❑ punoN,2 AlpBolul IeanlonalS ❑ 1 Alla6alul leinlonalS ❑ AlpBolu11eanlonalS ❑ wals�tg oNo s@A ❑ N el dwnd I ON SO), EiZ# WaiO Sad Cl G# 5lUel 'Molaq s]Uawwo7 ul UfejoXa '05)1 l-Dja 'S.lB/IVJ U04UJLI -sdwry uu/ob/w blur♦ Y07- ''a-/ 'wa4sAs sjg4 ul s)Iue4 abemas aya 6uissasse ajjgm suop/puoo ajesun jo sanssl leuol4eaado Aue Ap.juapi nog( p/O ' ON ❑ S2A F1 ON El �i8� (Peyoelle aas) aagl0❑ :6uldwnd and uoseaH :peoeldad Alaanoag saloH aoueualuleiN paanseaW a6pnls/wnOs alOH aoueualule :passaooy MOH 0>0 sa), ❑ o sad ❑ oN SGA ❑ :SUO1118E) ue ©dwn �1 1 d ON ❑ SOIL ❑ ON ❑ EGA ❑ ON ❑ SeA ❑ :suolleJ duel luawleaalaad ❑ o�❑ SOJ� El ON p sad EloN�p sad ElZ# � 4S2., :suolluo duel 6ulPIO4/olldag oAJ-0 Sal. ❑ o SOA ❑ of sak ❑ ' :suolleJ L# duel 6uIPIOg/o!ldaS . punosun lleinlonals aq of saeadda ao 'pamoesun 'palloejo gldap 6upeaado pou6lsep gldep 6ulleaado PaL"'- °ago) �ugl 1pe6ewap sI Janoo aloq aoueualuleyq aql enoge s� ua1 � uel, eql Moleq sNual �I b'a VOID ❑ 4seo ❑ �38gO ❑ :pOglaW luewhd 4 M' r Je J Ues lO 1SOO lelol � :d1Z/alelS/Allo :saleda» aaul0 :ead Ilnd 6uo-1 :ee j 6uldwnd :SSOjppv :aweN 3010ANI jau-� ullAanluaapaljdaseuunp :llew3 tb9LZ-L6-V-E9L :auOgc Wes [7] plNJS� Wir = aaulejuievy 98Ztb-l# 'alb vodA. wjo.i u®el3adsul 93ueua4uieW 9LE99 NW 'Iae110M '1S 3N any xneagu l 903 G 0�-j 'aainaaS aildeS aayam wir Jim Eicher Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376 r w T 1 _ , .^S " '�. iz' Maintenance Inspection Form MPCA Lic. #L4286 Maintainer Q Jim �WlNick F-71 Sam Phone: 763-497-2764 © Email: duaneseptic@centurylink.net INVOICE Pumping Fee: Name: �-e� Address: �-� !! Jo4V%_ (4)/' P-c Long Pull Fee: City/State/Zip: 10 Other Repairs: Total Cost of Sem L Payment Method: ❑ Check ❑ Cash ❑ Credit D✓� Tank leaks above the designed operating depth Maintenance hole cover is damaged, cracked, unsecured, or appears to be structural) unsound Tank (check k leaks below the operating depth ❑ Yes �'1Qo ❑ Yes 9—fTo Ct Septic/holding Tank #1 ❑ Yes 0- 0 Gallons: V-.o Septic/holding Tank #2 Gallons: 'Lp / ❑ Yes U(�Jo ❑ Yes / No ❑ Yes ❑<o ❑ Pretreatment Tank Gallons: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Ell -pump Tank Gallons: -Z',©-,qo ❑ Yes L 2 No ❑ Yes ❑ Yes .0--N'o How Accessed: aintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: ❑ Other (see attached)s ❑ No ❑ No . Al Did you Identify any operational issues or unsafe conditions while assessing the sewage tanks In this system, 1. e., - 1,.. 1-1— 1-1.rr 7 rf cn. ernlaln In comments below. Tank #1 ❑ Yes No Tank #2 ❑ Yes No Pump Tank ❑ Yes o 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 ❑ cr-domestic waste ❑ Ponding/Surfacing Effluent Filter creen ❑ Other: Cleaned? es ❑ No Comments: Disposal: o'Land Application: ❑ Wastewater Treatment Plant Disposal Site: Lime: /~ Gallons Za 0 Plowed: ❑ Yes El No Time: Temperature: �� `( pH: ( Z, `( > 12 Time: Temperature: _, �? pH. I L-V > 12 ❑ el < :Hd :ejnleJadwal :ew!l ❑ 3l < :Hd :aJnleJadwel :ewu ON ❑ sGA ❑ :pannold -'`-' ` suolleO :awl-1 :al!S lesodslc M Mom. IA V"') IUeI,4 lUawleaJl JaleMalSL' 11 :UOIle°Il°av Pue- I ❑ jubuuZ�lu :sluawwo0 ON ❑ SOA ❑ 0euealp :J8410 ❑ ueaJospalll3 luenl113 ❑ 6uloelmS/6ulpuod ❑ alsum ollsewop-UON ❑ sayoueJl ❑ sonss! IBOIJl0013 ❑ elseM allsawop-uoN 11elseM ollsewop uoN ❑ paq aJnssaJd ❑ salllue ❑ 6ulNeol sJaslu ❑ sal}leg ❑ 6uh{eal sieslu ❑ salllBg ❑ 6UIVel Slasld ❑ plolluleap palen813 ❑ puno(nl ❑ Alp5alul leJnlonJlS ❑ AllJ6alul leJnlonJls ❑ �(11J6alul IeJnlonJls ❑ wals�(S o q ❑ saA ❑ Muel dwnd I oN EI 6BA ❑ Z# �Upl ON .❑ sal. ❑ L# �luBl 'MOlaq s4uacuwu7 u! UlelUAv — d1 t .4u I-- —1-- +--+--+— — — — -- ' a 1 'uJaasxs s/ya u/ s)/ue4 a6eMas aya 6ulssasse allyM suoplpuoa ajesun jo sans! /euopejado Aue Aj/auapl nog( pl0 l ON ElSDA ❑ ON ElSax O (Payoelle aas) JaylO El :6uldwnd Jo3 uosea�! :paoeldad rtlaJnoas saloF{ eoueualulun paJnseaw ebpnlS/wnoS OIOH aoueualuleW ❑:passaooy MoF i auolleJ ON El SOA El ON. ❑ sa,� ❑ °N ❑ sad ❑ � uel dwnd ❑ :suOIIBJ ON ❑ SoA ❑ ON ❑ SGA ❑ ON ❑ SBA ❑ >luel luawleaJlaJd ❑ � , .'; � ' auoIIBJ ON sa], ❑ oN. p sal, ❑ oN L7 sa,� ❑ Z# duel 6u!Plou/opdeS ❑ molleg ON ❑ sad ❑ ON ❑ sad ❑ ON ❑ sad ❑ l# duel 6ulPlou/o!1daS ❑ punosun Allmnlonils 'pa�loeJo yldep 6ulleJedo peu6lsap yldep 6ulleJedo pe a.�� d 11 � oayo) � Uel eq of smadde Jo 'paJnoesun ayl enoge sNuel duel ayl Molaq s�leal 'pa6ewep sl Janoo aloy aoueuaIUMV4 ; ) }!POA0 ❑ ysaO ❑ O ❑ :Po4XaW Juawked F .... ;I/Ues 10 lsoO 1e10l :dlZ/al�1S/�1!0 I :sJI>;daH aay�O :eed Ilnd 6uo� :aed 6uldwnd :sseippy :ewuN 3310ANI lau-� ullAinlueOpoildeseu-enp :l!,ew:� . ti9L3-L6t,-E9L :auOud e wesl� �3!NLJ wlf JaulejulBn 99Ztll# '011 H0dW wjo.i uopedsuo eoueualuiew i 9L`OSS NN 'IaPPIN 'lS dN any xneaeel 90Z V 3�-j `aainaaS Oijdas