SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2020 - 017505, UID # 27104
Status: Report Submitted

Maintainer Information

Maintainer's Contact Information:

Name:

Ross Sewer Service

MPCA License #:

L3448

Business Name:

Ross Sewer Service

Phone:

(651

) 674

- 4349

Email:

noemail@noemail.com

Address:

9288 County Rd. 5 NE

North Branch	MN	55056

Code to use for this report:

r9676m17096

Date of Maintenance:

02/10/2020

Reason for Maintenance:

Home Sale

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
			2903221410006	19411 FOREST BLVD N, CITY OF FOREST LAKE	19411	FOREST	BLVD	N	FOREST LAKE	CITY OF FOREST LAKE	55025	NIPP ALEXANDER				1987

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: 2903221410006-SSTS_Mait._2020.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
Pump Tank - Leaking Out:	No
- Leaking In:	No
- Cover Damage:	No

Septage Removed

Tank #1:

1000 Gallons

Waste Disposal

Waste Disposal Method:	Land Apply
Location:	29052 Dimaggio St NE North Branch, MN 55056

Approvals

Approval	Signature
Applicant

Internal Notes

Text:
File(s):