SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0129, Submission # Submission-2016-0152, UID # 1639
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
System status on date: | 04/20/2016 | System Status: | Compliant |
Property Information
Property Information: | |||||||||||||||||
Owner's representative: |
|
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): | Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | Tanks pumped 4/15/2016 by Olson'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: | No |
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: | 104 Decimal Feet |
B. Periodically saturated soil/bedrock: | 100.7 Decimal Feet |
C. System separation: | 3.3 Decimal Feet |
D. Required compliance separation: | 3 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: |
Certification
Inspector: |
|
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 #783 (05/01/2016)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 05/01/2016 8:53 PM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
Grand Total | |||
Total | $40.00 | ||
Payment 05/01/2016 | $40.00 | ||
Due | $0.00 |
Action: Print
Approvals
Approval | Signature | Options |
---|---|---|
Applicant | Benjamin J. Zierke - 05/01/2016 8:53 PM 4ec70066a0a8c4c63c741874b33a58f2 3692b0daeb5d52b3cf1dc6da5d96eaf1 | |
#1 Compliance Inspection Accepted | Kati Hallermann - 05/04/2016 9:59 AM 8e5b08846995eec64011329053f3a61e 2a551f66c171faa1d61bb4ecc5eecefc |
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: |