Compliance Inspection Compliance Inspection Compliance Inspection # CI-2018-1530, Submission # Submission-2018-1579, UID # 18830
Status: Compliance Inspection Accepted
 

System Status

System status on date: 11/11/2018 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
16029212100018268 39TH ST N, CITY OF LAKE ELMO826839THSTNLAKE ELMOCITY OF LAKE ELMO55042GEISLER GAYLENE & THOMAS CHARLES8BORDNER'S GARNER FARMETTES1970
Owner's representative:
Name:
Aaron Quigley
Phone:
(651206 - 5133
Email:
aron@cardinalrealtors.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

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: 10/02/2014

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: 2.5 Decimal Feet
B. Periodically saturated soil/bedrock: 6 Decimal Feet
C. System separation: 3.5 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:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
David R. BrownL3649651-788-3296PO Box 251026 Woodbury, MN 55125NoNoNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: drufusb1@yahoo.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 #3967 (11/26/2018)

Charge Cost Quantity Total
Non-Taxable
added 11/26/2018 9:27 AM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 11/26/2018$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantDavid R. Brown - 11/26/2018 9:27 AM
758a89c1b8cc71c7f6e571bcf8fe2d9b
fea3faf9a6b7bd3cb0fac30597b760c7
 
#1 Compliance Inspection AcceptedKati Hallermann - 12/06/2018 11:35 AM
2a8c7adebe1288cffca8190347c40cba
119d90c9d61d807a7c915b67928e4ea3
 
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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