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0 <br />Ende Septic Service, LLC, MPCA Lic #L2654 <br />24910 Territorial Road • Rogers, MN 55374 <br />Phone: 763-428-4489 <br />email: info(,endeseptic.com <br />Maintenance ❑ Emergency ❑ Other <br />Maintenance Inspection Form <br />❑ Tristan ❑ Brandon ❑ Scott ❑ Dylan'l Seth <br />Disposal location: ❑ Land ap ❑ Treatment plant <br />Date: �� <br />'—� 3 <br />Invoice <br />Nam . <br />n rQ n a <br />W <br />Description: <br />Address: U95 <br />N At(yY1 <br />it <br />Total Cost of Service: <br />City/State/Zip: '<'orNo 5S3 <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />Tank (check if present) <br />ank leaks below the <br />ank leaks above t e <br />Maintenance hole cov is <br />Access point: ❑ Cover/maintenance hole; if so, were vers secured in place? ❑ Yes <br />signed operating <br />esoperat' g <br />damaged, cracke , <br />❑ Risers aking <br />depth <br />depth <br />u ecured, or appe s to be <br />❑ Bafes <br />❑ Baffle <br />❑ Baffles <br />tructurally and <br />❑ Sep ' /holding nk #1 <br />❑ Yes <br />❑ s ❑ No <br />Yes ❑ No <br />Gallo <br />❑ -domestic waste <br />❑ Septic/hol ng Tank #2 <br />❑ Yes ❑ No <br />es No <br />es ❑ No <br />Gallons: <br />❑ Yes ❑ No <br />Ta <br />❑ es ❑ No <br />❑ Yes ❑ No❑ <br />Yes ❑ <br />Vment <br />:ank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />Did you measure the accumulation of scum and sludge? Yes ❑ No `f / <br />It <br />07 <br />Q_1 ' <br />Access point: ❑ Cover/maintenance hole; if so, were vers secured in place? ❑ Yes <br />11 No <br />❑ Struc 1 inte <br />Tl7 <br />❑ Risers aking <br />Access point: ❑ Inspection pipe; if through pipe, did homeowner sign off ? ❑ 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.? /f so, explain in comments below. <br />)Xnk #1 ❑Yes No <br />ank #2 El Yes ❑ <br />P Tank ❑Yes ❑ <br />System <br />❑ St tura ntegrity <br />❑ S ctural in ity <br />❑ Struc 1 inte <br />❑ Risers aking <br />❑ Rise ea ' g <br />❑ Risers lea ' <br />❑ Bafes <br />❑ Baffle <br />❑ Baffles <br />❑ n -domes waste <br />❑ No omestt waste <br />❑ Elec ' al issues <br />Xddrain <br />❑ -domestic waste <br />ffluent filter cleaned? <br />❑ Yes ❑ No <br />Comments: <br />