SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2017-1040, Submission # Submission-2017-1081, UID # 11413
Status: Compliance Inspection Accepted

System Status

System status on date:

10/24/2017

System Status:

Compliant

Property Information

Property Information:

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
			0403221220003	23950 LAKE BLVD N, CITY OF FOREST LAKE	23950	LAKE	BLVD	N	FOREST LAKE	CITY OF FOREST LAKE	55025	KUPPE INVESTMENTS LLC

Owner's representative:

Name:

Michael McElhatton

Phone:

(651

) 462

- 1510

Email:

macsewer12@gmail.com

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 Homeowner testimony (See Comments/Explanation)	Comments/Explanation:	No other visible problems observed at the time of inspection.

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:	Tank pumped by Smilie's Pumping Service & deemed a good precast tank

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:

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.:	Yes
Drainfield meets the designed vertical separation distance from periodically saturated soil or bedrock.:	No
Verification method(s):	Conducted soil observation(s) (Attach boring logs)
Comments/Explanation:	Drainfield meets separation requirement and therefore meets compliance.
A. Bottom of distribution media:	12 Decimal Feet
B. Periodically saturated soil/bedrock:	44 Decimal Feet
C. System separation:	32 Decimal Feet
D. Required compliance separation:	24 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

Comments or recommendations:

Gravity Mound with Septic Tank.
NOTE: no records found-system is old approx. 37years old & most likely original (1980). Gravity mound CAUTION should be used to avoid overloading or abusing system which could cause failure.
Recommend cutting trees & brush on mound- keep grass established and mowed.

Attach Files:

File 1: 23950_LAKE_BLVD-SEPTIC_CERT.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
Mac's Sewer Services	L1476	651-462-1510	34918 Falcon Ave N North Branch, MN 55056	No	No	No	No	No

Please search for and choose SELF/OTHER if what you need does not appear in the list

Inspector Email Address:

macsewer12@gmail.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 #2852 (11/17/2017)

Charge	Cost	Quantity	Total
Non-Taxable
Compliance Inspection Fee added 11/17/2017 9:54 AM $40 Flat Fee	$40.00	x 1	$40.00
Subtotal			$40.00 0
Grand Total
Total			$40.00
Payment 11/17/2017			$40.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Mike McElhatton - 11/17/2017 9:54 AM - witnessed by Kati Hallermann 2c177ccbf609d8b80a06e23f68941d3d 3195bb76f09c8175386a35832a548ac6
#1 Compliance Inspection Accepted	Kati Hallermann - 11/17/2017 9:55 AM b5c7512c4fcd95295d8485f151ecda14 19d5ab86ee79c1c21a3184d4878bce00

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:
File(s):

Create Letter

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:

Letter of Compliance

Certificate of Compliance:

Letter of Non-Compliance

Letter of Non-Compliance: