SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2017 - 005046, UID # 8536
Status: Report Submitted
Maintainer Information
| Maintainer's Contact Information: |
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| Code to use for this report: |
b5013w4904 |
| Date of Maintenance: |
10/27/2016 |
| 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 |
|---|
| | | 2403221410011 | 10060 204TH ST N, CITY OF FOREST LAKE | 10060 | 204TH | ST | N | FOREST LAKE | CITY OF FOREST LAKE | 55025 | TOUSIGNANT RICHARD L & ANNE | 1 | 1 | SUNNY WAY ACRES PLAT 2 | 1963 | |
1
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| Maintenance Performed: |
Tank(s) Pumped
|
Access to Tanks
| Did you use the maintenance hole to remove septage: |
No |
Attach Copy of Report
| Describe the method used to remove the septage: |
No manway access pre 1978 |
| Attach maintenance Report: |
|
Maintenance Covers
| Were all covers securely replaced? |
Yes |
Evidence of Leaks or Damaged Covers
Septic/Holding Tank #1
- Leaking Out: |
No |
| - Leaking In: |
No |
| - Cover Damage: |
No |
Approvals
| Approval | Signature | Options |
|---|
| Applicant | | |
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10070-05042017074139.pdf