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Jim Eicher a� D Septic Service, LLC 1205 LaBeaux Ave NE St. Michael, MN 55376% rl ATC —7 1-1-74 Maintenance Inspection Form MPCA Lic. #L4286 Maintainer Jim � 'Nick • Phone: 763-497-2764 • Email: duaneseptic@centurylink.net INVOICE Pumping Fee: Name: t • ,n ` n Long Pull Fee: Address: Other Repairs: City/State/Zip: 6ro-�X'o Total Cost of Se e: Payment Method: ❑ Check ❑ Cash ❑ Credit F `s- 2 ..,o Tank (check if present) Tank leaks below the Tank leaks above the Maintenance hole cover is damaged, cracked, unsecured, or appears to be designed operating depth designed operating depth structural) unsound holding Tank #1 ❑ Yes to ❑ Yes C-IQo— ❑ Yes No Gallons: Gallons:��.� zr eptic/holding Tank #2 ❑ Yes �Ko ❑ Yes X0 ❑ Yes No Gallons: (act ❑ Pretreatment Tank ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No Gallons: ump Tank ❑ Yes Z No ❑ Yes ❑ Yes I- No Gallons: jQo 0 low Accessed: Z Maintenance Hole Scum/Sludge Measured Maintenance Holes Securely Replaced: Reason For Pumping: El Other (see attached) C�lYes ❑ No Yes El No Did you identify any operational issues or unsafe conditions while assessing the sewage tanks in this system, i.e., ,. i.,..a —1, ,«, „ hrwn, hr tb rrniarc ahr 7 rf cn_ eynlain in comments below. Tank #1 ❑ Yes No Tank #2 ❑ Yes o Pump Tank ❑ Yes o System ❑ Structural integrity ❑ Structural integrity ❑ Structural integrity rMound ❑ Risers leaking ❑ Risers leaking ❑ Risers leaking ❑ Elevated drainfield ❑ Baffles ❑ Baffles ❑ Baffles ❑ Pressure bed ❑ Non -domestic waste ❑ Non -domestic waste ❑ Electrical issues ❑ Trenches ❑ Non -domestic waste ❑ Ponding/Surfacing ❑ Effluent Filter/screen ❑ Other: Cleaned? ❑ Yes ❑ No Comments: Disposal: [+ and Application: ❑ Wastewater Treatment Plant )isposal Site: b l Lime: Gallons ZtLyO Plowed: El Yes o -ime: j? ') Temperature: (' Rio l pH: > 12 2'� -!me: Temperature: Lq.9 pH: Q.-I >12