Laserfiche WebLink
5v;h" <br />Ende Septic ervice, LLC <br />24910 Territorial Road • Rogers, MN 55374 <br />W6 <br />Maintenance Inspection Form <br />Phone. 7634284489 • e-mail. info(ct)endeseptc.com <br />MPGA License #: L2654tainer name: El Tristan ) T Brandon ❑ Scott <br />z, _ r am ❑ Dylan ❑ Keven <br />Date: <br />Invoice <br />Name: <br />Description: ,37-`�'p' 4_ � i� <br />a <br />Address: <br />Total Cost of Service:r <br />City/State/Zip: 1100111e, <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 Cho <br />allons: 1Z, 0 6S <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />gSeptic/holding Tank #2 <br />❑ Yes 1AN0 <br />❑ Yes R�No <br />❑ Yes 4 N <br />allons: <br />Cleaned. ❑ Yes ❑ No <br />❑ Pretreatmen Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />Pump Tan <br />❑ Yes A No <br />❑ Yes CK No <br />❑ Yes o LNo <br />Gallons: <br />Did you measure the accumulation of scum and sludge? 'es ❑ No <br />If the maintenance hole was used, were covers secured in place? 15\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 1� No <br />Tank #2 ❑ Yes o <br />Pump Tank ❑ Ye . 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 />C Other: <br />Cleaned. ❑ Yes ❑ No <br />Comments: <br />Is a mound cleaning recommended at this time: ❑ Yes RNo Next Service: 0 1 yr 0 2 yA 3 yr <br />