Compliance Inspection Compliance Inspection Compliance Inspection # CI-2018-1486, Submission # Submission-2018-1538, UID # 17849
Status: Compliance Inspection Accepted
 

System Status

System status on date: 10/10/2018 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
03029213300045170 JAMACA BLVD N, CITY OF LAKE ELMO5170JAMACABLVDNLAKE ELMOCITY OF LAKE ELMO55042LAMPLAND ERIC43FOX FIRE ESTATES1981
Owner's representative:
Name:
Jeffrey Fertig
Phone:
(651253 - 2969
Email:
jafertig@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
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):
Examined empty (pumped) tank(s)
Comments/Explanation:
Pumper testimony

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.:
No
Verification method(s):
Conducted soil observation(s) (Attach boring logs)
A. Bottom of distribution media: 30 Decimal Feet
B. Periodically saturated soil/bedrock: 60 Decimal Feet
C. System separation: 24 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:
1250-gallon septic tank, 1000-gallon lift tank and gravity flow trenches.
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Sunrise Septic Services, IncL2299651-253-296912180 St. Croix Trl North Branch, MN 55056NoNoNoNoYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: jafertig@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 #3874 (10/17/2018)

Charge Cost Quantity Total
Non-Taxable
added 10/17/2018 2:46 PM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 10/18/2018$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantJeffrey Fertig - 10/17/2018 2:46 PM - witnessed by Sharon Dischinger
1fdbba05ec80e4e7bad346e71cf9a162
4eca26421444d7c1d19e89af309547b5
 
#1 Compliance Inspection AcceptedSharon Dischinger - 10/18/2018 2:49 PM
b484a3cd82f9f57a9e77fb8aed7e1f70
4c5651efd94ce8bac6e7f70e83be99f6
 
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:
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