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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 Maintenance Inspection Form <br />Phone: 763-428-4489 • e-mail: info�uendeseptic.com <br />MPCA License #: L2654 // Maintainer <br />/Maintainer name: ❑ Tristan„ � Brandon ❑ Scott <br />IiLOL(�( ❑ Dylan ❑ Keven <br />Date: E — t 0 — Z( <br />Invoice <br />Name: �Onotkr <br />Description: <br />Address: Z a , <br />Total Cost of Service: <br />City/State/Zip: Z4+f'_ <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />Tank (check if present) <br />Tank leaks below the <br />Tank leaks above the <br />Maintenance hole cover is <br />❑ Structural integrity <br />designed operating <br />designed operating <br />damaged, cracked, <br />❑ Risers leaking <br />depth <br />depth <br />unsecured, or appears to be <br />❑ Baffles <br />❑ Baffles <br />❑ Baffles <br />structurally sound <br />Septic/holding Tank #1 <br />❑ Yes ( No <br />❑ Yes No <br />❑ Yes X10 <br />Gallons: Dub r <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />9Septic/holding Tank #2 <br />❑ Yes 8 No <br />❑ Yes KLNo <br />❑ Yes 1 No <br />Gallons: <br />Cleaned? ❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />5S Pump Tank <br />❑ Yes HSNo <br />❑ Yes allo <br />❑ Yes &No <br />Gallons: <br />Did you measure the accumulation of scum and sludge? qYes ❑ No <br />If the maintenance hole was used, were covers secured in place? 4ij Yes ❑ 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 VKNo <br />Tank #2 ❑ Yes ANo <br />Pump Tank ❑ Yes &,No <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />A Mound <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? ❑ Yes ❑ No <br />Comments: <br />Is a mound cleaning recommended at this time: 0 Yes DNo Next Service: ❑ 1 yr 112 yr A 3 yr <br />