SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2016 - 000047, UID # 1233
Status: Report Submitted
 

Maintainer Information

Maintainer's Contact Information:
Name:
James Vaughan
MPCA License #:
L3344
Business Name:
Tom's Sewer Service
Phone:
(651433 - 8700
Email:
septic@co.washington.mn.us
Address:
23020 Olinda Trl N
Scandia MN 55073
Code to use for this report: m5204t0722
Date of Maintenance: 12/31/2015
Reason for Maintenance: Routine

System Location & Maintenance Performed

Property Maintenance Performed :
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
010322121000223840 JULY AVE N, CITY OF FOREST LAKE23840JULYAVENFOREST LAKECITY OF FOREST LAKE55025GROSZ MITCHELL B1995
Maintenance Performed:
Tank(s) Pumped

Access to Tanks

Did you use the maintenance hole to remove septage: Yes

Maintenance Covers

Were all covers securely replaced? Yes

Tank Details

Tank#1: No
Verification Method Used: visual
Tank #2: No
Verification Method Used: visual

Evidence of Leaks or Damaged Covers

Septic/Holding Tank #1
- Leaking Out:
No
- Leaking In: No
- Cover Damage: No
Septic/Holding Tank #2
- Leaking Out:
No
- Leaking In: No
- Cover Damage: No

Septage Removed

Tank #1: 1000 Gallons
Tank #2: 1000 Gallons

Approvals

ApprovalSignature
Applicant 

Internal Notes

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