SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2018-1280, Submission # Submission-2018-1333, UID # 15471
Status: System Replaced

System Status

System status on date:

06/11/2018

System Status:

Noncompliant

System - Noncompliant

Reason(s) for noncompliance:

Tank Integrity (Compliance Component #2) - Failing to protect groundwater

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
			3202721110001	7810 113TH ST S, CITY OF COTTAGE GROVE	7810	113TH	ST	S	COTTAGE GROVE	CITY OF COTTAGE GROVE	55016	HICKEY WENDY E				1974

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

7810 113th st south

cottage grove	MN	55016

Owner's representative:

Name:

Bob Freiermuth

Phone:

(651

) 437

- 5566

Email:

bfsbob1@gmail.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:	Yes
Sewage tank(s) leak below their designed operating depth:	Yes
:	1st tank only
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:	No
Date of installation:	06/11/2018

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging?	No
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:	.28 Decimal Feet
B. Periodically saturated soil/bedrock:	.72 Decimal Feet
C. System separation:	.44 Decimal Feet
D. Required compliance separation:	.36 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: Engebertson_compliance.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
Bob Freiermuth Sanitation LLC	L492	651-437-5566	23620 Lillehei Ave Hampton, MN 55031	No	No	No	No	No

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

Inspector Contact (If 'self/other' is selected from the Inspector Lookup):

Bob Freiermuth

Inspector Email Address:

bfsbob1@gmail.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 #3361 (06/11/2018)

Charge	Cost	Quantity	Total
Non-Taxable
Compliance Inspection Fee added 06/11/2018 2:12 PM $40 Flat Fee	$40.00	x 1	$40.00
Subtotal			$40.00 0
Grand Total
Total			$40.00
Payment 06/11/2018			$40.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Bob Freiermuth - 06/11/2018 2:12 PM 40997759f794cade50c28cf516738682 b35e4835e5e5db7083fc4acc877b9c9e
#1 Compliance Inspection Accepted	Tyler Dale - 06/15/2018 9:01 AM 4097a01300f6cb522a1bee6dbb08239d 03f8a753e13dd7db688c694e5bb717f5

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:
File(s):

Create Letter

Compliance Letter Type:	Failed System, Notice and Order to Comply, Cesspool	Who's signature should be on the letter?	Tyler Dale	Permit number to reference in "No Replace" letter:
Was the letter sent?	Yes	Compliant/Non-Compliant:

Letter of Compliance

Certificate of Compliance:

Letter of Non-Compliance

Letter of Non-Compliance: