SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2021 - 021553, UID # 34214
Status: Report Submitted

Maintainer Information

Maintainer's Contact Information:

Name:

Ron Lindquist

MPCA License #:

L3070

Business Name:

R & M Septic & Sewer Service

Phone:

Mobile:

(651

) 674

- 8520

(651

) 775

- 7069

Fax:

(651

) 277

- 0424

Email:

randmseptic@aol.com

Address:

37654 Falcon Ave

North Branch	MN	55056

Code to use for this report:

c4563r23178

Date of Maintenance:

06/15/2021

Reason for Maintenance:

Compliance inspection

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
			0503221230002	23690 FLAY AVENUE CT N, CITY OF FOREST LAKE	23690	FLAY AVENUE	CT	N	FOREST LAKE	CITY OF FOREST LAKE	55025	LOR XIONG & HOUA V	5	1	TAYLOR PARK	1992

Maintenance Performed:

Tank(s) Pumped

Access to Tanks

Did you use the maintenance hole to remove septage:

Yes

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

Septage Removed

Tank #1:

1500 Gallons

Waste Disposal

Waste Disposal Method:	Land Apply
Location:	37654 Falcon Ave, North Branch, MN 55056

Approvals

Approval	Signature
Applicant

Internal Notes

Text:
File(s):