SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2019-1808, Submission # Submission-2019-1902, UID # 22660
Status: System Replaced

System Status

System status on date:

07/22/2019

System Status:

Noncompliant

System - Noncompliant

Reason(s) for noncompliance:

Tank Integrity (Compliance Component #2) - Failing to protect groundwater

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
			0103221230006	23545 JENSEN AVE N, CITY OF FOREST LAKE	23545	JENSEN	AVE	N	FOREST LAKE	CITY OF FOREST LAKE	55025	FRENCH BILLY J	5	4	HUNTER'S HILL	1988

Owner's representative:

Name:

Billy French

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 Homeowner testimony (See Comments/Explanation) Other methods not listed (See Comments/Explanation)	Comments/Explanation:	At the time of my inspection, I observed lush and very dark green grass growing over the first trench of the drainfield. This may be an indicator that the drainfield may be at the end of its useful life. In addition, the drainfield is sized for a three bedroom house, the house is now a four bedroom house and is undersized by approximately 144 feet.

Tank Integrity

System consists of seepage pit, cesspool, drywell, or leaching pit:	Yes
Sewage tank(s) leak below their designed operating depth:	Yes
Verification method(s):	Probed tank(s) bottom Examined construction records Observed liquid level below operating depth Other methods not listed (See Comments/Explanation)
Comments/Explanation:	Pumper indicated a crack in bottom of the septic tank.

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:	09/23/1988

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging?	No
Drainfield has at least a two-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:	Reviewed design and permit records.
A. Bottom of distribution media:	1.8 Decimal Feet
B. Periodically saturated soil/bedrock:	3.8 Decimal Feet
C. System separation:	2 Decimal Feet
D. Required compliance separation:	2 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:

File 1: 23545_Jensen_Ave_N.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 #4634 (07/23/2019)

Charge	Cost	Quantity	Total
Non-Taxable
Compliance Inspection Fee added 07/26/2019 9:31 AM $41 Flat Fee	$41.00	x 1	$41.00
Subtotal			$41.00 0
Grand Total
Total			$41.00
Payment 07/31/2019			$41.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Brian Humpal - 07/26/2019 9:31 AM ed81d380c0caab7f913e8e40e3ca8811 cb20aa57ce3cd8245ea42c0e58e87eaf
#1 Compliance Inspection Accepted	Paul O'Neel - 08/01/2019 10:10 AM 4b92b798d650ba9b572081ee320e05b3 baa5a811295fc792bc5079839af5cb24

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:
File(s):

Create Letter

Compliance Letter Type:	Failed System, Notice and Order to Comply, Cesspool	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:

Letter of Compliance

Certificate of Compliance:

Letter of Non-Compliance

Letter of Non-Compliance: