SSTS Permitting

System Status

System status on date:

03/25/2019

System Status:

Noncompliant

System - Noncompliant

Reason(s) for noncompliance:

Impact on Public Health (Compliance Component #1) - Imminent threat to public health and safety

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
			2202820140004	3465 ST CROIX TRL S, CITY OF AFTON	3465	ST CROIX	TRL	S	AFTON	CITY OF AFTON	55001	LUTZ ANDREW J & EMILY E WALDHART				1996

Owner's representative:

Name:

Matthew Snelling

Phone:

(123

) 456

- 7890

Email:

noemail@email.com

Impact on Public Health

System discharges sewage to the ground surface:	Yes	System discharges sewage to drain tile or surface waters:	No	System causes sewage backup into dwelling or establishment:	No
Verification method(s):	Other methods not listed (See Comments/Explanation)	Comments/Explanation:	The end of the seepage bed is exposed and is discharging effluent to the ground surface.

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 methods not listed (See Comments/Explanation)
Comments/Explanation:	Lowered underwater camera into tanks- baffles and tank walls OK. Lift pump and alarm were operational at the time of the inspection.

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?	Yes
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) Other (See Comments/Explanation)
A. Bottom of distribution media:	27 Decimal Feet
B. Periodically saturated soil/bedrock:	60 Decimal Feet
C. System separation:	33 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

Comments or recommendations:	Property owner email: snelling@outlook.com
Attach Files:	File 1: 3465_St._Croix_Trail_S.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
Midwest Sewer Services	L2896	651-492-7550	6616 Indian Wells Trail Grant, MN 55110	Yes	Yes	Yes	Yes	Yes

Please search for and choose SELF/OTHER if what you need does not appear in the list

Inspector Email Address:

brian@midwestsoiltesting.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 #4144 (03/26/2019)

Charge	Cost	Quantity	Total
Non-Taxable
Compliance Inspection Fee added 03/27/2019 3:48 PM $41 Flat Fee	$41.00	x 1	$41.00
Subtotal			$41.00 0
Grand Total
Total			$41.00
Payment 03/27/2019			$41.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Brian Humpal - 03/27/2019 3:48 PM ba6cea57b20964a90dc924af6550b857 1d852b6fd818d9ae8aa40e5a026af2f4
#1 Compliance Inspection Accepted	Joe Sanders - 04/03/2019 1:17 PM 90c216d23c477d75c03eb8dd4d8e4abc 4962957f845b109e3503f4330bcbd2ee

Inspection has been approved. All signatures have been obtained.

Compliance Letter Type:	Imminent Threat, Abatement Notice and Order	Who's signature should be on the letter?	Tyler Dale	Permit number to reference in "No Replace" letter:
Was the letter sent?	Yes	Compliant/Non-Compliant:

Text:	Talked with the home owner 4/15/19. System has been pumped and is currently not in use. The system is going to be abandoned and then hooked up to Afton's sewer.
File(s):