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Ende Septic Service, LLC <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-428-4489 • e-mail: into(a,endeseptic.com <br />Maintenance Inspection Form <br />MPCA License #: L2654 Mainta�er arae: ElTristanrandon ❑ Scott <br />G / ❑ Dvlan ❑ Keven <br />Date: u <br />Invoice <br />Name: ,,- j An <br />Description: <br />Address; ,� Q �T��S <br />Total Cost of Services"/Z. S" <br />designed operating <br />Payment Method: El 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 l No <br />❑ Yes [� No <br />❑ Yes C 'No <br />allons: GQ <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />fSeptic/holding Tank #2 <br />❑ Yes [�l No <br />❑ Yes f�l No <br />El Yes No <br />allons: �d <br />Cleaned? ❑ Yes ❑ No <br />1 <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />Pump Tank <br />❑ Yes A No <br />❑ Yes X No <br />❑ Yes �l No <br />Gallons: <br />Did you measure the accumulation of scum and sludge? L Yes ❑ No <br />If the maintenance hole was used, were covers secured in place? ,-Yes ❑ No <br />Didyou identify any operational issues or unsafe conditions while assessing the sewage tanks in this systerrr, i.e., <br />cracked tanks, missing baffles, broken covers, etc.? If so, explain in comments belotiv. <br />Tank #1 ❑ Yes 4 No <br />Tank #2 ❑ Yeses No <br />Pump Tank ❑ Yes tNo <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />'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 A No Next Service: 0 1 yr 0 2 yr t3 yr <br />