SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2018-1292, Submission # Submission-2018-1332, UID # 15455
Status: Compliance Inspection Accepted

System Status

System status on date:

04/28/2018

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
			1403220430016	21020 OZARK AVE N, CITY OF SCANDIA	21020	OZARK	AVE	N	SCANDIA	CITY OF SCANDIA	55073	POTEK ARNOLD S & NANCY L	9	1	HAWKINSON BUSINESS PARK	2001

Owner's representative:

Name:

Amy Thompson

Phone:

(320

) 980

- 0235

Email:

atsepticinspection@noemail.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):	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:

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):	Conducted soil observation(s) (Attach boring logs)
A. Bottom of distribution media:	30 Decimal Feet
B. Periodically saturated soil/bedrock:	66 Decimal Feet
C. System separation:	36 Decimal Feet
D. Required compliance separation:	36 Decimal Feet

Operating Permit and Nitrogen BMP

Is system operating under an Operating Permit:	Yes
Is the system required to employ Nitrogen BMP:	Yes

Operating Permit

A. Operating Permit number:	2017-0073
B. Have the Operating Permit requirements been met?	Yes
C. Is the required nitrogen BMP in place and properly functioning?	Yes

Comments and File Attachments

Comments or recommendations:

Bar/Restaurant 1500gallons septic tank, 1500 gallon split tank with pump, 6000 gallon tank with nibbler ATU, 1500gallon clearifier tank, 1500gallon pump tank and trenches.
Office building 1500gallon septic tank, 1500gallon septic tank, 1000gallon tank and trenches

Attach Files:

File 1: 21050-06072018132547.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
AT Septic Inspection & Design Inc	L3886	320-980-0235	49861 Government Rd Rush City, MN 55069	Yes	Yes	Yes	Yes	Yes

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

Inspector Email Address:

atsepticinspection@noemail.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 #3357 (06/08/2018)

Charge	Cost	Quantity	Total
Non-Taxable
Compliance Inspection Fee added 06/08/2018 2:55 PM $40 Flat Fee	$40.00	x 1	$40.00
Subtotal			$40.00 0
Grand Total
Total			$40.00
Payment 06/21/2018			$40.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Amy Thompson - 06/21/2018 2:46 PM - witnessed by Kati Hallermann cff3d14296073f1d4402a799149ce745 a26d02ce54ba1aa3d2e9ce7a0e2a7882
#1 Compliance Inspection Accepted	Kati Hallermann - 06/21/2018 2:46 PM 1d6286229f38a932bf089364df7f8f06 35386dd86c10dd0e164bef85bdff931b

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:	Address Correction: 21050 Ozark Ave- Scandia is not a valid address correct address is 21020 Ozark Ave- Scandia
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: