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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 />'F Maintenance ❑ Emergency ❑ Other <br />Maintenance Inspection Form <br />❑ Tristan (56Brandon ❑ Scott ❑ Kurt ❑ Robert <br />Disposal location: )j Land ap ❑ Treatment plant <br />Date: 5 . a 9 a <br />Invoice <br />Name: <br />Description: <br />Address: l f- KCL <br />Total Cost of Service: <br />City/State/Zip: QV -Ono <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 />❑ S rural integrity <br />designed operating <br />designed operating <br />damaged, cracked, <br />❑ Risers aking <br />depth <br />depth <br />unsecured, or appears to be <br />❑ Baffles <br />❑ Baffle <br />❑ Baffles <br />structurally sound <br />eptic/holding Tank #1 <br />❑ Yes El No <br />❑ Yes 11 No <br />❑ Yes El No <br />ons: <br />❑ Non-domesti aste <br />❑ Ponding/surfacing <br />❑ Septic h ding Tank #2 <br />❑Yes []No <br />❑Yes ❑ No <br />❑Yes ❑ No <br />Gallons: <br />❑ Yes ❑ No <br />❑ Pretreatment Ta <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />❑ Pump Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />Did you measure the accumulation of scum and sludge?,R'.Yes ❑ No <br />Access point: 19 Cover/maintenance hole; if so, were covers secured in place? '9 Yes ❑ No <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.? If so, explain in comments below. <br />k #1 ❑ Yes []No <br />ank #2 ❑ Yes ❑ No <br />Pump Tank ❑ Yes ❑ No <br />System <br />❑ S rural integrity <br />❑ ctural integrity <br />❑ ctural integrity <br />Mound <br />❑ Risers aking <br />❑Ris leaking <br />❑Ris leaking <br />Elevated drainfield <br />❑ Baffles <br />❑ Baffle <br />❑ Baffles <br />❑ Pressure bed <br />❑ Non -domes ' waste <br />❑ Non -dome 'c waste <br />❑ Electrical ues <br />❑ Trenches <br />❑ Non-domesti aste <br />❑ Ponding/surfacing <br />❑ Effluent filter cleaned? <br />❑ Other: <br />❑ Yes ❑ No <br />Comments: V lti Com_ c-(, <br />Le_ss +ho_n <br />lo V-rk s►lV G <br />5 °� j to-nv- <br />uolVA-rr-'< <br />N ur"-JL4r <br />