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Field Maintenance Report Form Person Calling: Operator Responding: ]� Date/Time Called: Datet7ime Responded: Address: Total Field Time: Phone: Total Travel'Gime: Service Calls Alarm Call Addendum Type of System: Conditions Leading to Cali Meter Readings(refer to ETM/CT Log&Worksheet) ❑Alarm ❑Tank Overflow Days Since Last Reading: ❑Odor ❑Surface Runoff Today's CT El Noise ❑Sewage Backup Today's ETM: ❑Other: Frequency(CT/Days): ❑Normal ❑High ❑Low Odor Duration(MinJCycle): Normal: ❑Musty ❑Earthy ❑Moldy ❑Nominal ❑High ❑Low Pungent: ❑Sulfite ©Cabbage ❑Decay Typical average daily flow: Date/Time Discovered: / Typical average weekly flow: Method of Detection: Pump Test Alarm Pump Pump#1:Tank Pump ❑High Liquid Level ❑On Voltage at Rest: ❑tow Liquid Level ❑Off Voltage while Pumping: p Off Amps while Pumping: Pumping Head(Ft.): Tank Liquid level Circuit Breaker Shutoff Head(Ft.): ❑Normal ❑On Drawdown Time(Min.&Sec.): ❑High ❑Off Drawdown Depth(Inches): ❑Low ❑Tripped Pump#2:Discharge Pump ❑Switched Vottage at Rest: Cause of Malfunction Voltage while Pumping: Mechanical Physical or Process-Related Amps while Pumping: E]Control Panel ❑Power Pumping Head(Ft.): ❑Pump ❑Back Pressure Shutoff Head(Ft.): ❑Float Switch EJ Air Bound Odor ❑Screened Vault ❑Sludge&Scum Normal: ❑Musty ❑Earthy ❑Moldy ❑Hose&Valve ❑Clog Pungent: ❑Sulfite EJ Cabbage ❑Decay ❑Check Valve ❑InfittrationAnflow Method of Detection: ❑Building Sewer ❑E>diltration Squirt Height: ❑Service Line ❑Siphoning ❑Other: ❑Other. Valve Position at Departure Hose&Valve Assembly: ❑Open ❑Closed Repair: End of Laterals: ❑Open ❑Closed Replace: Controt/Alarm Switch at Departure MOA ❑Manual ❑Off ❑Auto CB: ❑On ❑Off Repair. Replace: Observation: Action: Comment: