SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2016 - 000239, UID # 1572
Status: Report Submitted

Maintainer's Contact Information:

Name:

Larry Schlomka

MPCA License #:

L2989

Business Name:

Schlomka Services LLC

Phone:

(651

) 459

- 3718

Email:

septic@co.washington.mn.us

Address:

Code to use for this report:

k4524r1205

Date of Maintenance:

10/12/2015

Reason for Maintenance:

Routine

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
			1602921210006	3889 INNSDALE AVE N, CITY OF LAKE ELMO	3889	INNSDALE	AVE	N	LAKE ELMO	CITY OF LAKE ELMO	55042	LAMBERT LYNN C	13		BORDNER'S GARNER FARMETTES	1973

Maintenance Performed:

Tank(s) Pumped

Did you use the maintenance hole to remove septage:

Yes

Were all covers securely replaced?

Yes

Tank#1:	No
Tank #2:	No

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

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

Approval	Signature	Options
Applicant		Status must be

Internal Notes

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