SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0190, Submission # Submission-2016-0202, UID # 2130
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 05/13/2016 | System Status: | Compliant |
Property Information
| Property Information: | |||||||||||||||||
| Owner's representative: |
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[ Search Result Limit: 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): | Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | See Report |
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): | Other methods not listed (See Comments/Explanation) |
| Comments/Explanation: | See Report |
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: | See Report |
| System is non protective of groundwater for other conditions as determined by the inspector: |
No |
| Explain: | See Report |
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) |
| Comments/Explanation: | See Report |
| A. Bottom of distribution media: | 0 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 0 Decimal Feet |
| C. System separation: | 0 Decimal Feet |
| D. Required compliance separation: | 0 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: | VBWD See Report |
| Attach Files: |
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2102820440007-Comp_Insp-2016.pdfCertification
| Inspector: |
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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 #899 (05/26/2016)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 05/27/2016 2:10 PM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
| Grand Total | |||
| Total | $40.00 | ||
| Payment 06/08/2016 | $40.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Brian Humpal - 05/27/2016 2:10 PM 4e6944553f2b4b3d889333bc96ed80fb c593a00865e987cfe07845c0ca422d9b | |
| #1 Compliance Inspection Accepted | Kati Hallermann - 06/09/2016 12:20 PM afb17f3c57982265f1d9494be647c7e5 f2b94e6eb077b697a8acd77e2a433074 |
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: |