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Ende Septic Service, LLC, MPCA Lic #L2654 <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-4284489 <br />email: info(&endeseptic.com <br />-viD Maintenance ❑ Emergency ❑ Other <br />Maintenance Inspection Form <br />❑ Tristan ❑ Brandon ❑ Scott 7` Dylan ❑ <br />Disposal location: ❑ Land ap ❑ Treatment plant <br />Date: /���� <br />Invoice <br />Name: <br />Description: <br />Address: 1 1, � � <br />Total Cost of Service:�j <br />City/State/Zip: (7(7)nU „tJ <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 />❑ Baf s <br />structurally sound <br />k7 Septic/holding Tank #1 <br />❑ Yes P'No <br />❑ Yes ❑ No <br />❑ Yes J1 No <br />Gallons: <br />11N,Qd-do estic waste <br />11Ponding/surfacing <br />-S Septic/holding Tank #2 <br />❑ Yes -rid No <br />❑ Yes XI No <br />❑ Yes El No <br />Gallons:-Y"-',� <br />❑ Yes Nq <br />ent Tank <br />❑ Yes ❑ No <br />El El No <br />CTYes El No <br />_'PatTons: <br />— --- --- <br />❑ Pump Tank <br />❑ Yes ❑ No <br />No <br />❑ Yes ❑ No <br />Did you measure the accumulation of scum and sludge? V Yes ❑ No <br />Access point: k� Cover/maintenance hole; if so, were covers secured in place? '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 hill No <br />Tank #2 ❑ Yes ® No <br />Puiltp Tank ❑ Yes 0 X <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ St ctural integrityMound <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Ris s leaking <br />E) Elevated drainfield <br />❑ Baffles <br />❑ Baffles <br />❑ Baf s <br />ElPressure bed <br />ElNon-domesticwaste <br />❑ Non-domestic waste <br />❑ Elect} al issues <br />❑ Trenches <br />11N,Qd-do estic waste <br />11Ponding/surfacing <br />❑.Effluent ter cleaned? <br />❑Other: <br />❑ Yes Nq <br />Comments: <br />