SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2019 - 016444, UID # 25805
Status: Report Submitted

Maintainer Information

Maintainer's Contact Information:

Name:

Larry Schlomka

MPCA License #:

2989

Business Name:

Schlomka Services

Phone:

(651

) 459

- 3718

Email:

office@schlomkaservices.com

Address:

1303 S Frontage Rd, Suite 135

Hastings	MN	55033

Code to use for this report:

x7723d17406

Date of Maintenance:

12/23/2019

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
			3202721440002	12085 GREY CLOUD TRL S, CITY OF COTTAGE GROVE	12085	GREY CLOUD	TRL	S	COTTAGE GROVE	CITY OF COTTAGE GROVE	55016	GILBERSTADT TERRYL S & DAVID C				1959

Maintenance Performed:

Tank(s) Pumped

Access to Tanks

Did you use the maintenance hole to remove septage:

Attach Copy of Report

Attach maintenance Report:

File 1: IMG_0001.pdf

Maintenance Covers

Were all covers securely replaced?	No
:	not used

Tank Details

Tank#1:

Evidence of Leaks or Damaged Covers

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

Septage Removed

Tank #1:

1000 Gallons

Waste Disposal

Location:

Metro

Other Information

Notes/Comments:

No MH located. some answers are unknown

Approvals

Approval	Signature
Applicant

Internal Notes

Text:
File(s):