SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0108, Submission # Submission-2016-0128, UID # 1495
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 04/17/2016 | System Status: | Compliant |
Property Information
| Property Information: | |||||||||||||||||
| Owner's representative: |
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[ Search Result Limit: 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 Homeowner testimony (See Comments/Explanation) |
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 |
| Comments/Explanation: | Reviewed recent inspection report from another party. |
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: | 04/17/1992 |
Soil Separation
| Shoreland/Wellhead Protection/Food, beverage, lodging? | No |
| Drainfield has at least a two-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: | 4 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 7 Decimal Feet |
| C. System separation: | 3 Decimal Feet |
| D. Required compliance separation: | 2 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: |
1703021340037-Comp_INsp-2016April.pdfCertification
| Inspector: |
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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 #722 (04/17/2016)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 04/17/2016 10:42 AM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
| Grand Total | |||
| Total | $40.00 | ||
| Payment 04/18/2016 | $40.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Ed Eklin - 04/17/2016 10:43 AM 5df76cfeaf7c0202ae52f4c35195a0fb 57b76b292104c60bb51e4baab84f96ce | |
| #1 Compliance Inspection Accepted | Kati Hallermann - 04/18/2016 3:06 PM 47f5050fa8451c2ae1a0d7cdd50a7486 d9fc2433c2bc74468d7e216f26a1000f |
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: |