Compliance Inspection Compliance Inspection Compliance Inspection # CI-2019-1637, Submission # Submission-2019-1707, UID # 20946
Status: Compliance Inspection Accepted
 

System Status

System status on date: 04/23/2019 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
360272131001311640 LEEWARD AVE S, CITY OF COTTAGE GROVE11640LEEWARDAVESHASTINGSCITY OF COTTAGE GROVE55033LENNES RAYANNA35PINE COULEE1974
Owner's representative:
Name:
Joey Menden
Phone:
(952445 - 4809
Email:
carrie@bohnwell.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: 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.:
No
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: 30 Decimal Feet
B. Periodically saturated soil/bedrock: 84 Decimal Feet
C. System separation: 54 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:
Standard Drainfield (Cham) Sept 1500gal  1100gal & Pump 1000gal
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Bohn Well Drilling CompanyL1043952-445-480918190 Dairy Ln Ste 101 Jordan, MN 55352NoYesNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: carrie@bohnwell.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 #4243 (04/29/2019)

Charge Cost Quantity Total
Non-Taxable
added 04/29/2019 2:13 PM

$41 Flat Fee

$41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 04/29/2019$41.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantBohn well drilling - 04/29/2019 2:14 PM - witnessed by Kati Hallermann
00fc27ac3d6fcbd397b741de1f39f782
b4a80f61df7a4d555382623d07e71cd2
 
#1 Compliance Inspection AcceptedKati Hallermann - 04/29/2019 2:15 PM
c3254e7876ac9923e770c44a23362f67
cd436b4f511c2db04c64f6fab541fb94
 
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:
          Powered by