SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2024 - 036638, UID # 57059
Status: Report Submitted

Maintainer Information

Maintainer's Contact Information:

Name:

Leah A Synicyn

MPCA License #:

L3287

Business Name:

Hassle Free Septic

Phone:

(763

) 222

- 4397

Fax:

(763

) 222

- 4397

Email:

leah.hasslefree@gmail.com

Address:

PO Box 702

North Branch	MN	55056

Code to use for this report:

j9366h38001

Date of Maintenance:

11/22/2024

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
			2503221410001	19400 KEYSTONE AVE N, CITY OF FOREST LAKE	19400	KEYSTONE	AVE	N	FOREST LAKE	CITY OF FOREST LAKE	55025	RICE ANDREW J & KIMBERLEY S				1926

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:	No
Tank #2:	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

Septage Removed

Tank #1:	1500 Gallons
Tank #2:	1000 Gallons

Waste Disposal

Waste Disposal Method:	Land Apply
Location:	North Branch

Approvals

Approval	Signature
Applicant

Internal Notes

Text:
File(s):