SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2019 - 016273, UID # 25590
Status: Report Submitted

Maintainer Information

Maintainer's Contact Information:

Name:

LeeAnn M Weigt

MPCA License #:

216

Business Name:

Olson's Sewer Service

Phone:

(651

) 464

- 2082

Email:

ossi1@olsonsinthepink.com

Address:

17638 Lyons Street NE

Forest Lake	MN	55025

Code to use for this report:

i9625r17708

Date of Maintenance:

11/22/2019

Reason for Maintenance:

Other

If 'Other' then enter reasons here:

Tank abandonment

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
			1703021420014	47 EVERGREEN RD, CITY OF DELLWOOD	47	EVERGREEN	RD		WHITE BEAR LAKE	CITY OF DELLWOOD	55110	ROACH TODD A & RENEE T	4	6	PINE TREE HILLS	1974

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: 47EvergreenRd.pdf

Maintenance Covers

Were all covers securely replaced?

Yes

Tank Details

Tank#1:	No
Verification Method Used:	visual

Evidence of Leaks or Damaged Covers

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

Septage Removed

Tank #1:

2000 Gallons

Waste Disposal

Waste Disposal Method:	Treatment Plant
Location:	metro st paul

Other Information

Notes/Comments:

This tank was pumped for removal/abandonment.

Approvals

Approval	Signature
Applicant

Internal Notes

Text:
File(s):