SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2023 - 030748, UID # 48646
Status: Report Submitted

Maintainer Information

Maintainer's Contact Information:

Name:

Row Sewer Service - Mark

MPCA License #:

L3309

Business Name:

Ross Sewer Service

Phone:

(651

) 465

- 5505

Email:

noemail@noemail.com

Address:

P.O. Box 236 412 Bench St.

Taylors Falls	Mn	55084

Code to use for this report:

a7918j32809

Date of Maintenance:

09/05/2023

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
			3603221220003	9363 190TH ST N, CITY OF FOREST LAKE	9363	190TH	ST	N	FOREST LAKE	CITY OF FOREST LAKE	55025	VAUGHAN WILLIAM S & SHARON L FEEHAN				1972

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: 3603221220003-Maintenance_Report-2023.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

Septage Removed

Tank #1:

1000 Gallons

Waste Disposal

Waste Disposal Method:	Land Apply
Location:	Al Peltier Fields 00.0089.00

Approvals

Approval	Signature	Options
Applicant		Status must be

Internal Notes

Text:
File(s):