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Septic maintenance form 6-18-2024
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Septic maintenance form 6-18-2024
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Last modified
6/18/2024 11:37:27 AM
Creation date
6/18/2024 11:37:18 AM
Metadata
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Template:
x Address Old
House Number
3205
Street Name
Graham Hill
Street Type
Road
Document Type
Septic
PIN
2222
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Ende Septic Service, LLC, MPCA Lie #L2654 <br />24910 Tentorial Road • Rogers, MN 55374 <br />Phone: 763-42813489 <br />email: infoCo)endeseptic.com <br />fMaintenance ❑ Emergency ❑ Other <br />Maintenance Inspection Form <br />❑ Tristan Jq Brandon ❑ Scott ❑ Kurt ❑ Robert <br />( (Disposal location: EI Land ap AQ Treatment plant <br />Date: — <br />— a <br />Invoice <br />Name: <br />S e hC,h Q OttwIc&n/p <br />Description: 7aS,OC t <br />Address: 37-0- <br />&v*_k4t <br />( fZd <br />Total Cost of Service: '45s,, �J <br />City/State/Zip: <br />y- n p <br />Payment Method: ❑ Check ❑ Cash ❑ Credit <br />;10941 <br />Tank (check if present) <br />Tank leaks below the <br />designed operating <br />Tank leaks above the <br />designed operating <br />Maintenance hole cover is <br />damaged, cracked, <br />❑ Structural integrity <br />depth <br />depth <br />unsecured, or appears to be <br />❑ Risers leaking <br />❑ Risers leaking <br />❑ Risers leaking <br />structurally sound <br />�I Septic/holding Tank #1 <br />❑ Yes No <br />❑ Yes No <br />❑ Yes 43 No <br />allons: I p <br />❑ Non-domestic waste <br />❑ Electrical issues <br />❑ Trenches <br />❑ Non-domestic waste <br />❑ Ponding/surfacing <br />49,Septic/holding Tank #2 <br />❑ Yes No <br />❑ Yes No <br />❑ Yes I No <br />Gallons: <br />❑ Yes ❑ No <br />❑ Pretreatment Tank <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />❑ Yes ❑ No <br />Gallons: <br />($.Pump Tank <br />❑ Yes O No <br />❑ Yes 47t No <br />❑ Yes .@KNo <br />Gallons: <br />Did you measure the accumulation of scum and sludge? I&LYes ❑ No <br />Access point: KCover/maintenance hole; if so, were covers secured in place? Ames ❑ No <br />Access pointer Inspection pipe; if through pipe, did homeowner sign off ?177er^ff�Tdo <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 />Tank #1 ❑ Yes IkNo <br />Tank #2 ❑ Yes U -No <br />Pump Tank ❑ Ye$9LNo <br />System <br />❑ Structural integrity <br />❑ Structural integrity <br />❑ Structural integrity <br />A 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 cleaned? <br />❑ Other: <br />❑ Yes ❑ No <br />Comments: <br />
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