SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0132, Submission # Submission-2016-0136, UID # 1534
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 03/23/2016 | 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 Searched for seeping in yard/backup into home Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | Holding Tank - See Report |
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 empty (pumped) tank(s) Other methods not listed (See Comments/Explanation) |
| Comments/Explanation: | See Report |
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: | No |
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): | Not applicable (Holding tank(s), no drainfield) |
| A. Bottom of distribution media: | 0 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
| Attach Files: |
2602822130002-Comp_Insp-20160323.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 #750 (04/22/2016)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 04/22/2016 11:13 AM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
| Grand Total | |||
| Total | $40.00 | ||
| Payment 05/04/2016 | $40.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Brian Humpal - 04/22/2016 11:13 AM 9b5057017ef4a9de44e54aad239e4686 319feff0dc79a6a427be1637198705e7 | |
| #1 Compliance Inspection Accepted | Kati Hallermann - 05/05/2016 7:46 AM 77d34d88d69fc049fb984332ed261fef 75953c203e63a3bc9babfcbf1e219774 |
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: |