SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2024 - 036157, UID # 54238
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:

b7586k35483

Date of Maintenance:

09/19/2024

Reason for Maintenance:

Other

If 'Other' then enter reasons here:

Abandonment and replaced

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
			1303221140011	10255 217TH ST N, CITY OF FOREST LAKE	10255	217TH	ST	N	FOREST LAKE	CITY OF FOREST LAKE	55025	NORBY ELVIN G & LEVERNE C				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: John_Johnson_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:

1250 Gallons

Waste Disposal

Waste Disposal Method:	Land Apply
Location:	2.1.15408

Other Information

Notes/Comments:

Abandonment

Approvals

Approval	Signature	Options
Applicant		Status must be

Internal Notes

Text:
File(s):