SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2016 - 000245, UID # 1578
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:

o4101a1211

Date of Maintenance:

10/15/2015

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
			0302921210008	9719 55TH ST N, CITY OF LAKE ELMO	9719	55TH	ST	N	LAKE ELMO	CITY OF LAKE ELMO	55042	PAWLUK GARTH R & SUSAN M	8	2	JUDITH MARY MANOR	1999

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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