Compliance Inspection Compliance Inspection Compliance Inspection # CI-2023-3414, Submission # Submission-2018-1384, UID # 15868
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/22/2018 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
24027223400059877 GREY CLOUD ISLAND DR S, TOWN OF GREY CLOUD ISLAND9877GREY CLOUD ISLANDDRSST PAUL PARKTOWN OF GREY CLOUD ISLAND55071TYLER SHAUNA M1958
Owner's representative:
Name:
Shelley Schlomka/Dennis Schlomka
Phone:
(320384 - 7911
Email:
sssepticcolutions@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):
Other methods not listed (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 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: Yes
Date of installation: 09/05/1989

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.:
No
Verification method(s):
Other (See Comments/Explanation)
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

Comments or recommendations:
Report incomplete- waiting for completed report (2018). COMPLETE report submitted 1/2/2023.
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Schlomka Services LLCL2989651-459-371817560 Northfield Blvd Hastings, MN 55033YesNoNoNoNo
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: sssepticsolutions@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 #3480 (07/11/2018)

Charge Cost Quantity Total
Non-Taxable
added 07/11/2018 1:19 PM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 07/11/2018$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantShelley Schlomka - 01/03/2023 10:39 AM - witnessed by Sarah Borrell
ef95512dce7553e18b35aece7c464a3b
4f8dfe7f0a2ef53b13ce45ab5e0fb989
 
#1 Compliance Inspection AcceptedSarah Borrell - 01/03/2023 10:39 AM
6fa768ad0d9f9b63554ab629e431e69e
8affdd8273eebe511aee892f42c14316
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    In 2018 this report was returned to author as it was incomplete (report submitted was blank). Requested copy of completed report in 2022; see attached. 1987 permit file has additional background.
    File(s):
    Compliance Letter Type: Certificate of Compliance Who's signature should be on the letter? Sarah Borrell Permit number to reference in "No Replace" letter:
    Was the letter sent? Yes Compliant/Non-Compliant: Compliant
    Certificate of Compliance:
      Letter of Non-Compliance:
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