SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2016 - 000577, UID # 2155
Status: Report Submitted

Maintainer's Contact Information:

Name:

Keith Valento

MPCA License #:

L3885

Business Name:

A&B Sanitation Service

Phone:

(651

) 433

- 2000

Email:

septic@co.washington.mn.us

Address:

Code to use for this report:

w7486t1791

Date of Maintenance:

12/02/2015

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
			2403221420009	20340 KEATS AVE N, CITY OF FOREST LAKE	20340	KEATS	AVE	N	FOREST LAKE	CITY OF FOREST LAKE	55025	MOSZER MICHAEL J & SANDRA M	4	1	SUNNY WAY ACRES	1978

Maintenance Performed:

Tank(s) Pumped

Did you use the maintenance hole to remove septage:

Describe the method used to remove the septage:	see report
Attach maintenance Report:	File 1: 2403221420009-maintenance_report-20151202.pdf

Were all covers securely replaced?

Yes

Tank#1:	No
Verification Method Used:	visual/precast

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

Tank #1:

1200 Gallons

Approval	Signature	Options
Applicant		Status must be

Internal Notes

Text:
File(s):