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Ende Septic Service, LLC <br />24910 Territorial Road - Rogers, MN 55374 <br />Phone: 763-4284489 - e-mail: info(icendeseptic.coin <br />MPCA License #: L2654 <br />Maintenance Inspection Form <br />Maintainer name: ❑ Tristan biPBrandon ❑ Scott <br />❑ Dylan ❑ Keven <br />Date: (O • CO) 3- <br />a <br />Invoice <br />Nom; <br />n <br />Description: <br />Address; <br />damaged, cracked, <br />❑ Risers leaking <br />Total Cost of Service: <br />City/SW /Zip; <br />j lty <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />Tank (check K present), <br />Tank leaks below the. <br />Tank leaks above the <br />Maintenance.hoie cover is <br />❑ Structural integrity <br />designed operating <br />designed operating <br />damaged, cracked, <br />❑ Risers leaking <br />depth <br />depth <br />unsecared, or appeirp.to be <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />stracturow sound <br />Septic/holding Tank #1 <br />❑ Yes XNo <br />❑ Yes 1�bNo <br />❑ Yes ?No <br />Gallons: <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />RSeptic/holding Tank #2 <br />❑ Yes )<No <br />❑ YesbN0 <br />ID Yes �eNo <br />Gallons: <br />Cleaned? Poyes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />'SZ Pump Tank <br />❑ Yes JNo <br />❑ Yes I kNo <br />❑ Yes ;5,No <br />Gallons: <br />Did you measure the accumulation of scum and sludge? ❑ Yes F�,No <br />If the maintenance hole was used, were covers secured in place? pYes ❑ No <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 ❑ Yes No <br />Tank #2 ❑ Yes 1Si;DNo <br />Pump Tank RYes ❑ No - <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrityMound <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/screen <br />❑ Other: <br />Cleaned? Poyes ❑ No <br />Comments: <br />Is a mound cleaning recommended at this time: 0 Yes �No Next Service: ❑ 1 yr ❑ 2 yr "3 yr <br />