SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0091, Submission # Submission-2016-0116, UID # 1461
Status: Compliance Inspection Accepted

System Status

System status on date:

03/19/2016

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
			2903119330002	13055 ST CROIX TRL N, TOWN OF MAY	13055	ST CROIX	TRL	N	STILLWATER	TOWN OF MAY	55082	GEORGIEFF MICHAEL & DAWN				1895

Property Owner's Mailing Address
(if different than property address):

932 Fairmount Ave

St. Paul	MN	55105

Owner's representative:

Name:

Carmel Carver, Coldwell Banker Burnet Realty

Phone:

(651

) 430

- 7761

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):	Examined construction records Examined empty (pumped) tank(s)

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:	11/03/2014

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging?	Yes
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)
A. Bottom of distribution media:	18 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

Comments or recommendations:

2 1000 gallon infiltrator plastic septic tanks and 1000 gallon infiltrator plastic pump tank pumping up to a 18" sand lift mound.
This system was installed in November 2014. The house has been un-occupied since then, The tanks have very little water in them. Lifted the float to operate the pump, everything is in good working order.

Attach Files:

File 1: 2903119330002-Comp_Insp-20160319.pdf

Certification

Inspector:

Name:

Tom Trooien

MPCA License #:

L1568

Business Name:

All State Septic Services

Phone:

(651

) 439

- 7323

Email:

tomtrooien@aol.com

Address:

12020 Square Lake Trail Ct N

Stillwater	MN	55082

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 #697 (04/12/2016)

Charge	Cost	Quantity	Total
Non-Taxable
Compliance Inspection Fee added 04/12/2016 1:52 PM $40 Flat Fee	$40.00	x 1	$40.00
Subtotal			$40.00 0
Grand Total
Total			$40.00
Payment 04/12/2016			$40.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Tom Trooien - 04/12/2016 1:52 PM - witnessed by Kati Hallermann 7f238fa88498fdb81bd6f95908f836ba a50203f49e4fdeacbed74e27b2f657a6
#1 Compliance Inspection Accepted	Kati Hallermann - 04/12/2016 1:53 PM 6ffe57a9e0a8a9adf43a7ede9408143e b27d31e9306cfdda7d21b5aa85e0c9fd

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: