SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2018-1513, Submission # Submission-2018-1568, UID # 18559
Status: Compliance Inspection Accepted

System Status

System status on date:

11/05/2018

System Status:

Compliant

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
			0502620210002	13450 122ND ST S, TOWN OF DENMARK	13450	122ND	ST	S	HASTINGS	TOWN OF DENMARK	55033	LAMOREUX LOGANN E & NICHOLAS E WAXON				2005

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

13450 122nd
st so.
hastings	Mn	55033

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:	No
Sewage tank(s) leak below their designed operating depth:	No
Verification method(s):	Probed tank(s) bottom Examined construction records Examined Tank Integrity Form (Attach) 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:	06/23/2005

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) Two previous verifications (Attach boring logs)
Comments/Explanation:	1-13" top soil 10yr3/4,13-36"10yr4/6 silt loam,36-44' fine sand 10yr5/6, 44-55"10yr6/4 med sand end of bore
A. Bottom of distribution media:	.12 Decimal Feet
B. Periodically saturated soil/bedrock:	.55 Decimal Feet
C. System separation:	.43 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: larry_schlomka.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 #3944 (11/13/2018)

Charge	Cost	Quantity	Total
Non-Taxable
Compliance Inspection Fee added 11/13/2018 2:04 PM $40 Flat Fee	$40.00	x 1	$40.00
Subtotal			$40.00 0
Grand Total
Total			$40.00
Payment 11/13/2018			$40.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Bob Freiermuth - 11/13/2018 2:04 PM 6242497ff1324d9d07a0ba973e3fe57f 2bad5eecb61dcd7ddfd5843c6873599f
#1 Compliance Inspection Accepted	Kati Hallermann - 11/20/2018 12:53 PM 81b30a6c5112aac3b5bc99d9b5a543be d5577143cd2108e5f4d74719d4457184

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:
File(s):

Create Letter

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:

Letter of Compliance

Certificate of Compliance:

Letter of Non-Compliance

Letter of Non-Compliance: