SSTS Permitting

SSTS Maintenance Report SSTS Maintenance Report Report # Pump Report - 2017 - 005078, UID # 8581
Status: Report Submitted

Maintainer Information

Maintainer's Contact Information:

Name:

Ron's Sewer Service

MPCA License #:

L3690

Business Name:

Rons Sewer Service

Phone:

Mobile:

(715

) 749

- 0153

(715

) 441

- 0689

Email:

ronssewerservice@gmail.com

Address:

W6621 610th Ave

Ellsworth	WI	54011

Code to use for this report:

a6243k6334

Date of Maintenance:

05/12/2017

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
			1102820430117	1882 RACINE AVE S, CITY OF LAKE ST CROIX BEACH	1882	RACINE	AVE	S	STILLWATER	CITY OF LAKE ST CROIX BEACH	55082	MITCHELL NICHOLAS W & AMBER L				1994

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:	1000 Gallons
Tank #2:	1000 Gallons

Waste Disposal

Waste Disposal Method:

Treatment Plant

Approvals

Approval	Signature	Options
Applicant		Status must be

Internal Notes

Text:
File(s):