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4-24-24 septic pumping report
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4-24-24 septic pumping report
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5/9/2024 9:37:27 AM
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cher <br /> Maintenance Inspection Form <br /> MPCA Lic. #L4286 <br /> Maintainer ❑ Jim <br /> ►l ick <br /> Service, LLC • Phone: 763-497-2764 <br /> Beaux Ave NE <br /> ael, MN 55376 • Email: duaneseptic@centurylink.net <br /> 4i." 2 S- 2' INVOICE <br /> Fee: Name: <br /> (-i, Zs. 0 k.ky t 5 -3-- -1 5 <br /> I Fee: Address: <br /> pairs: 'City/State/Zip: <br /> C L \. <br /> n ��,l� I.\ vt�Q,A 0 <br /> st of Service: Payment Method: ❑ Check ❑ Cash ❑ Credit <br /> 433 -7.sc- <br /> Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, <br /> k(check if pre �� designed operating depth designed operating depth cracked, unsecured,or appears to be <br /> structurally unsound <br /> Bolding Tank#1 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No <br /> c <br /> Bolding Tank#2 ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No <br /> Lcy <br /> tment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No <br /> Eank ❑ Yes 0 No ❑ Yes ❑ No ❑ Yes ❑ No <br /> a t% <br />)ssed:❑Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: <br /> lcle;J .}c,..k S <br /> ❑Other(see attached) ❑ Yes ❑ No ❑ Yes 0 No ;:, .t <br /> �y <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 /> ❑ Yes ❑ No Tank#2 ❑ Yes ❑ No Pump Tank ❑ Yes ❑ No System <br /> tructural integrity ❑ Structural integrity ❑ Structural integrity ❑ Mound <br /> lisers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield <br />'raffles ❑ Baffles ❑ Baffles ❑ Pressure bed <br /> Ion-domestic waste ❑ Non-domestic waste ❑ Electrical issues ❑Trenches <br /> ❑ Non-domestic waste ❑ Ponding/Surfacing <br /> ❑ Effluent Filter/screen ❑ Other: <br /> Cleaned? ❑ Yes ❑ No <br /> ts: <br /> Disposal: ❑ Land Application: O stewater Treatment Plant I <br /> Site: Lime: Gallons 7.04,r-) Plowed: 0 Yes ❑ No <br /> Temperature: pH: >12 ❑ <br /> Temperature: pH: >12 0 <br /> esilD THANKS! ,. ,, els • <br /> �`',r sue. --� ,. -'�-�, �`'� .sue. <br />
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