SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2019 - 015016, UID # 23788
Status: Report Submitted

Maintainer Information

Maintainer's Contact Information:

Name:

Gerald Helm

MPCA License #:

268

Business Name:

Dan's Sewer Service

Phone:

(763

) 786

- 1498

Email:

noemail@noemail.com

Address:

7971 Jackson St. NE

Spring Lake Park	MN	55432

Code to use for this report:

g3425i17097

Date of Maintenance:

09/10/2019

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
			2503221430003	9960 190TH ST N, CITY OF FOREST LAKE	9960	190TH	ST	N	FOREST LAKE	CITY OF FOREST LAKE	55025	JOINT REV TRS DOUGLAS P & BONNIE K NORD				1977

Maintenance Performed:

Tank(s) Pumped

Access to Tanks

Did you use the maintenance hole to remove septage:

Yes

Attach Copy of Report

Attach Maintenance Report:

File 1: 9960_190th_St._N._Forest_Lake_-_D._Nord._-_Dans_Sewer_Service.pdf

Maintenance Covers

Were all covers securely replaced?

Yes

Tank Details

Tank#1:

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
Pump Tank - Leaking Out:	No
- Leaking In:	No
- Cover Damage:	No

Septage Removed

Tank #1:	1200 Gallons
Pump Tank:	400 Gallons

Waste Disposal

Waste Disposal Method:

Land Apply

Approvals

Approval	Signature
Applicant

Internal Notes

Text:
File(s):