SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2018 - 009691, UID # 15682
Status: Report Submitted

Maintainer Information

Maintainer's Contact Information:

Name:

Steven Rossini

MPCA License #:

Homeowner

Business Name:

Homeowner

Phone:

(000

) 000

- 0000

Email:

hoomeowner@noemail.com

Address:

15040 Everton Ave N

Hugo	MN	55038

Code to use for this report:

v9597k10795

Date of Maintenance:

06/11/2018

Reason for Maintenance:

Routine

System Location & Maintenance Performed

Property Maintenance Performed :

Compliance Status		Property Record		Property Address								Property Owner	Property Attributes
Compliance Expiration	Compliance Status	Parent GeoCode	PIN	Site Address	Building Number	Street Name	Type	Dir	City	Municipality	zip	Owner	Lot	Block	Plat	Year Built	Property Hold
			1803121340001	15040 EVERTON AVE N, CITY OF HUGO	15040	EVERTON	AVE	N	HUGO	CITY OF HUGO	55038	HOLM MICHAEL & DIANE				1978

Maintenance Performed:

Sludge and Scum Measured

Pumping Needed

Do tanks need to be pumped?

Tank Measurements

Liquid Level of Tank:	1257 Inches	Sludge Level:	2.5 Inches	Scum Level:	2 Inches
Total Sludge & Scum:	4.50	/ Liquid Level:	1257.0000000000	= % of Sludge & Scum:	0.36%

Access to Tanks

Did you use the maintenance hole to remove septage:

Attach Copy of Report

Attach maintenance Report:

File 1: 15040-06272018091319.pdf

Maintenance Covers

Were all covers securely replaced?	No
:	No pumping

Tank Details

Tank#1:

Evidence of Leaks or Damaged Covers

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

Septage Removed

Tank #1:

0 Gallons

Approvals

Approval	Signature
Applicant

Internal Notes

Text:
File(s):