SSTS Permitting

Compliance Inspection Compliance Inspection Submission # Submission-2018-1252, UID # 15084
Status: Canceled

System Status

System status on date:

05/09/2018

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
			3503021430017	10555 62ND ST N, CITY OF GRANT	10555	62ND	ST	N	STILLWATER	CITY OF GRANT	55082	WIRTH JEFFREY P & ANGELA M	17		SANDEEN'S HEIGHTS	1977

Owner's representative:

Name:

Tom Trooien

Phone:

(651

) 439

- 7323

Email:

tomtrooien@aol.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

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

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging?	Yes
Drainfield has at least a two-foot vertical separation distance from periodically saturated soil or bedrock:	Yes
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

Comments and File Attachments

Attach Files:

File 1: 10555_62nd_St_N_comp_report.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
All State Septic Services	L1568	651-439-7323	12155 Norell Ave N Stillwater, MN 55082	No	No	No	Yes	Yes

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

Inspector Email Address:

tomtrooien@aol.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 #3209 (05/09/2018)

Charge	Cost	Quantity	Total
Grand Total
Total			$0.00
Due			$0.00

This Application was canceled, so you may not pay for this Invoice.

Action: Print

Approvals

Approval	Signature	Options
Applicant	Tom Trooien - 05/09/2018 5:24 PM 453bca3f67f2c28fa977e01e11ea7b19 3117a95ae6392e1d11bc5e4639f3d3bc
#1 Compliance Inspection Accepted		Status must be Pending Review

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: