SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2022 - 026028, UID # 41107
Status: Report Submitted
Maintainer Information
| Maintainer's Contact Information: |
|
| Code to use for this report: |
r7999v25626 |
| Date of Maintenance: |
10/25/2021 |
| Reason for Maintenance: |
Routine |
System Location & Maintenance Performed
| Property Maintenance Performed : |
Find:
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| 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 |
|---|
| | | 1103221220004 | 22790 IMPERIAL AVE N, CITY OF FOREST LAKE | 22790 | IMPERIAL | AVE | N | FOREST LAKE | CITY OF FOREST LAKE | 55025 | HENDRICK JASON & ROBIN | 14 | 1 | CAMERON HIGHLANDS | 1998 | |
1
|
| 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: |
|
Maintenance Covers
| Were all covers securely replaced? |
Yes |
Tank Details
| Tank#1: |
No |
| Tank #2: |
No |
| Tank#4: |
No |
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: |
1000 Gallons |
| Tank #2: |
1000 Gallons |
| Pump Tank: |
250 Gallons |
Waste Disposal
| Waste Disposal Method: |
Land Apply |
| Location: |
29052 Dimaggio St. NE North Branch, MN 55056 |
Approvals
| Approval | Signature | Options |
|---|
| Applicant | | |
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1103221220004-Maintenance_Report-2022.pdf