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Compliance Inspection Compliance Inspection Compliance Inspection # CI-2019-1666, Submission # Submission-2019-1713, UID # 20963
Status: System Replaced
 

System Status

System status on date: 04/30/2019 System Status: Noncompliant

System - Noncompliant

Reason(s) for noncompliance:
Soil Separation (Compliance Component #4) - Failing to protect groundwater

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
25028221100022721 BAILEY RD, CITY OF NEWPORT2721BAILEYRDNEWPORTCITY OF NEWPORT55055JOHNSON DAVID & ROZLYN1979
Owner's representative:
Name:
Dave Johnson
Phone:
(123) 456 - 7890
Email:
noemail@email.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
Excessive ponding in soil system/D-boxes

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
Other methods not listed (See Comments/Explanation)
Comments/Explanation: 
Lowered underwater camera into tank- baffles and tank walls OK.

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
Explain: 
Install year: 1979
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.:		 No
Verification method(s):
Conducted soil observation(s) (Attach boring logs)
Comments/Explanation: 
7.5YR 2.5/2 Silt loam (0-10")
10YR 4/4 Silt loam (10-20")
7.5YR 4/3 Sandy loam (20-35")
7.5YR 3/4 Loam (35-48")
5YR 4/4 Silt loam moist w/ 10YR 5/3 Layers w/ few 7.5YR 5/8 Redox (48-62")
Refusal at 62"
A. Bottom of distribution media: 3 Decimal Feet
B. Periodically saturated soil/bedrock: 4 Decimal Feet
C. System separation: 1 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
Midwest Sewer ServicesL2896651-492-75506616 Indian Wells Trail Grant, MN 55110YesYesYesYesYes
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 #4252 (05/01/2019)

Charge Cost Quantity Total
Non-Taxable
added 05/03/2019 10:25 AM

$41 Flat Fee

 $41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 05/03/2019$41.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantBrian Humpal - 05/03/2019 10:25 AM
1141b5ef242adfa36a2cc1b4a7bd3bf7
a1dd2a4c41e448292f7e91423deb5bcf		 
#1 Compliance Inspection AcceptedTyler Dale - 05/08/2019 12:50 PM
efaf6c80cddda06fa8c80097259f2b91
111e95e9e04992afd4c0293fa781386f		 
Inspection has been approved. All signatures have been obtained.
Text: 




File(s):

    		

    

    

    

    

    


    

    Text:

    05/07/2019: Reviewed for completion. Needs to be approved. PMO
    		

    

    File(s):

      		

      

      

      

      

      


      

      Compliance Letter Type:
Failed System, Notice and Order to Comply, Separation
Who's signature should be on the letter?
Paul O'Neel
Permit number to reference in "No Replace" letter:


      

      Was the letter sent?
Yes
Compliant/Non-Compliant:


      

      

      

      

      


      

      Certificate of Compliance:

        		

        

        

        

        

        


        

        Letter of Non-Compliance:

          		

          

          

          

          

          


          

		
          
		
		
          

          
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