SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0114, Submission # Submission-2016-0141, UID # 1628
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
System status on date: | 04/16/2016 | System Status: | Compliant |
Property Information
Property Information: | |||||||||||||||||
Property Owner's Mailing Address (if different than property address): |
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Owner's representative: |
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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 Excessive ponding in soil system/D-boxes Homeowner testimony (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): | Probed tank(s) bottom Examined construction records |
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: | 04/04/1984 |
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: |
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) |
Comments/Explanation: | B1 0-11 Topsoil 10yr 3/2 11-45 medium sand 10yr 4/3 45-66 loamy sand 10yr 4/4 |
A. Bottom of distribution media: | 24 Decimal Feet |
B. Periodically saturated soil/bedrock: | 0 Decimal Feet |
C. System separation: | 36 Decimal Feet |
D. Required compliance separation: | 24 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: | See Attached |
Attach Files: |
Certification
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 #772 (04/28/2016)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 04/28/2016 1:38 PM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
Grand Total | |||
Total | $40.00 | ||
Payment 04/28/2016 | $40.00 | ||
Due | $0.00 |
Action: Print
Approvals
Approval | Signature | Options |
---|---|---|
Applicant | Tom Trooien - 04/28/2016 1:52 PM - witnessed by Kati Hallermann e2cc3a29dfec7ab0d64e7ad99bc60abc 2be2ae12ce6e58fda256655083c0da7e | |
#1 Compliance Inspection Accepted | Kati Hallermann - 04/28/2016 1:52 PM 5c6e1d580b50258d3088f1d2822ce689 f2f7d5093665bf39b0e4ed9afb3a9ace |
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: |