Compliance Inspection Compliance Inspection Compliance Inspection # CI-2018-1160, Submission # Submission-2018-1207, UID # 14500
Status: Compliance Inspection Accepted
 

System Status

System status on date: 03/21/2018 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
31028214200146775 CRACKLEBERRY TRL, CITY OF WOODBURY6775CRACKLEBERRYTRLWOODBURYCITY OF WOODBURY55129HARTSHORN STEPHEN R & LYNN G31ORCHARD RIDGE ESTATES1996
Owner's representative:
Name:
Malee Vang
Phone:
(651332 - 4569
Email:
malee.vang@evusa.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

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: 09/01/1996

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.:
Yes
Verification method(s):
Conducted soil observation(s) (Attach boring logs)
A. Bottom of distribution media: 3 Decimal Feet
B. Periodically saturated soil/bedrock: 6 Decimal Feet
C. System separation: 3 Decimal Feet
D. Required compliance separation: 3 Decimal Feet

Operating Permit and Nitrogen BMP

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

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Sewer Works II LLCL2015763-753-161117725 Nowthan Blvd Anoka, MN 55303YesYesNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Contact (If 'self/other' is selected from the Inspector Lookup): Jeffrey Peterson
Inspector Email Address: sewerworks@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 #3134 (04/11/2018)

Charge Cost Quantity Total
Non-Taxable
added 04/11/2018 5:03 PM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 04/11/2018$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantJeffrey R. Peterson - 04/11/2018 5:03 PM
181aae42de8b6c1e282ae6dfea540238
acb27c4cc81da551bdb109e8d4feb593
 
#1 Compliance Inspection AcceptedKati Hallermann - 04/12/2018 7:37 AM
cb223276c223f5b2e98034a9d509d23c
8ba8ce270cb0039d756cd62c80dca3e4
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    Invoice#3134
    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:
          Powered by