SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2024 - 036156, UID # 52879
Status: Report Submitted

Maintainer Information

Maintainer's Contact Information:

Name:

THOMAS A. CARLISLE

MPCA License #:

L1675

Business Name:

Sherco Construction Inc

Phone:

Mobile:

(651

) 462

- 1817

(612

) 366

- 3472

Fax:

(651

) 462

- 3960

Email:

tom.carlisle@shercohomebuilders.com

Address:

79 North Lake Street

Forest Lake	MN	55025

Code to use for this report:

u1381m35482

Date of Maintenance:

10/16/2023

Reason for Maintenance:

Other

If 'Other' then enter reasons here:

Abonnement

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
			0603021130006	11635 GRENELEFE AVE N, CITY OF GRANT	11635	GRENELEFE	AVE	N	WHITE BEAR LAKE	CITY OF GRANT	55110	DOMIN RYAN J & JESSICA L	1	3	NORTHRIDGE ACRES	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: Ryan_Domin_Pump.pdf

Maintenance Covers

Were all covers securely replaced?	No
:	tanks being crushed and buried

Tank Details

Tank#1:	No
Verification Method Used:	see report

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:	2.1.10589.03

Other Information

Notes/Comments:

Abandonment

Approvals

Approval	Signature	Options
Applicant		Status must be

Internal Notes

Text:
File(s):