SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2017-1004, Submission # Submission-2017-1049, UID # 11141
Status: System Replaced
Status: System Replaced
System Status
System status on date: | 10/19/2017 | System Status: | Noncompliant |
System - Noncompliant
Reason(s) for noncompliance: | Impact on Public Health (Compliance Component #1) - Imminent threat to public health and safety |
Property Information
Property Information: | |||||||||
Owner's representative: |
|
Impact on Public Health
System discharges sewage to the ground surface: |
Yes | 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 |
Comments/Explanation: | System is surfacing onto the ground |
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): | Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | System is failed |
Other Compliance Conditions
Maintenance hole covers are damaged, cracked, unsecured, or appear to be structurally unsound: |
Unknown |
Other issues (electrical hazards, etc.) to immediately and adversely impact public health or safety: |
Unknown |
System is non protective of groundwater for other conditions as determined by the inspector: |
No |
Date of Install
Date of install known: | No |
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.: |
No |
Verification method(s): | Other (See Comments/Explanation) |
Comments/Explanation: | system is failed |
A. Bottom of distribution media: | 0 Decimal Feet |
B. Periodically saturated soil/bedrock: | 0 Decimal Feet |
C. System separation: | 0 Decimal Feet |
D. Required compliance separation: | 0 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
Attach Files: |
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Certification
Inspector: |
Please search for and choose SELF/OTHER if what you need does not appear in the list
|
Inspector Email Address: | brian@midwestsoiltesting.com |
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 #2745 (10/20/2017)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 10/20/2017 5:52 AM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
Grand Total | |||
Total | $40.00 | ||
Payment 10/20/2017 | $40.00 | ||
Due | $0.00 |
Action: Print
Approvals
Approval | Signature | Options |
---|---|---|
Applicant | Brian Humpal - 10/20/2017 5:52 AM 7f6147b875c6acd12c91d636deaf6997 0bfc48d1f412683f9a8216e24a7dccab | |
#1 Compliance Inspection Accepted | Alex Pepin - 10/27/2017 12:46 PM 7840ac964c2619ecfdc9c065e5dcf6ba fefdf725ef305bcf9ab811e280e4f317 |
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: |