Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0228, Submission # Submission-2016-0054, UID # 1067
Status: Compliance Inspection Accepted
 

System Status

System status on date: 02/22/2016 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
28029211200231873 IVORY AVE N, CITY OF LAKE ELMO1873IVORYAVENLAKE ELMOCITY OF LAKE ELMO55042YANG LEO & LOU MOUA155PARKVIEW ESTATES2000
Property Owner's Mailing Address
(if different than property address):
Kenneth & Annette Hanson
1873 Ivory Ave N
Lake Elmo MN 55042
Owner's representative:
Name:
CIty of Lake Elmo
Email:
septic@co.washington.mn.us

Impact on Public Health

System discharges sewage to
the ground surface:
No System discharges sewage to
drain tile or surface waters:
No System causes sewage backup
into dwelling or establishment:
No
Verification method(s):
Searched for surface outlet
Searched for seeping in yard/backup into home

Tank Integrity

System consists of seepage pit,
cesspool, drywell, or leaching pit:
No
Sewage tank(s) leak below their
designed operating depth:
No
Verification method(s):
Probed tank(s) bottom
Examined construction records

Other Compliance Conditions

Maintenance hole covers are damaged, cracked,
unsecured, or appear to be structurally unsound:
No
Other issues (electrical hazards, etc.) to
immediately and adversely impact public
health or safety:
No
System is non protective of groundwater for other
conditions as determined by the inspector:
No

Date of Install

Date of install known: Yes
Date of installation: 06/19/2001

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging? No
Drainfield has at least a three-foot vertical separation
distance from periodically saturated soil or bedrock.:
No
Drainfield meets the designed vertical separation
distance from periodically saturated soil or bedrock.:
Yes
Verification method(s):
Two previous verifications (Attach boring logs)
Comments/Explanation:
See attached soil info
A. Bottom of distribution media: 40 Decimal Feet
B. Periodically saturated soil/bedrock: 72 Decimal Feet
C. System separation: 36 Decimal Feet
D. Required compliance separation: 36 Decimal Feet

Operating Permit and Nitrogen BMP

Is system operating under an Operating Permit: No
Is the system required to employ Nitrogen BMP: No

Comments and File Attachments

Certification

Inspector:
Name:
Ryan Lashinski
MPCA License #:
L65
Business Name:
Lashinski Services
Phone:
(612919 - 3704
Address:
1326 161st Ave NW
Andover MN 55304

Terms

Certification
  • By submitting this form I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of the future
    system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, inadequate
    maintenance, or future water usage

Invoice #543 (02/25/2016)

Charge Cost Quantity Total
Non-Taxable
added 02/25/2016 1:46 PM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 06/29/2016$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantRyan Lashinski - 06/29/2016 10:31 AM - witnessed by Kati Hallermann
c21794eaad46e9025956c3c0b5fcc1a3
d9474d6e7bebf95dcf2962c521839764
 
#1 Compliance Inspection AcceptedKati Hallermann - 06/29/2016 10:31 AM
10226ff94c697360f6ad5256d257e4b3
cd46e65500f5bb6fb2db5babbc42b535
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    File(s):
      Compliance Letter Type: Who's signature should be on the letter? Permit number to reference in "No Replace" letter:
      Was the letter sent? Compliant/Non-Compliant:
      Certificate of Compliance:
        Letter of Non-Compliance:
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