SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2019-1843, Submission # Submission-2019-1921, UID # 22941
Status: System Replaced

System Status

System status on date:

07/30/2019

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
			3202920140011	690 NOVAK AVE N, TOWN OF WEST LAKELAND	690	NOVAK	AVE	N	STILLWATER	TOWN OF WEST LAKELAND	55082	KLOEBER DAVID N JR	5	1	WYNSTONE	1993

Owner's representative:

Name:

Dave Kloeber

Phone:

(000

) 000

- 0000

Email:

no@no.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):	Searched for surface outlet Searched for seeping in yard/backup into home Excessive ponding in soil system/D-boxes Other methods not listed (See Comments/Explanation)	Comments/Explanation:	At the time of my inspection, there was a large amount of effluent surfacing onto the ground. This drainfield is at the end of its useful life.

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:	Lowered underwater camera into tanks - 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
System is non protective of groundwater for other conditions as determined by the inspector:	No

Date of Install

Date of install known:

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) Other (See Comments/Explanation)
Comments/Explanation:	Septic Installed: 2005
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

Attach Files:

File 1: 690_Novak_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 #4683 (08/02/2019)

Charge	Cost	Quantity	Total
Non-Taxable
Compliance Inspection Fee added 08/02/2019 4:27 PM $41 Flat Fee	$41.00	x 1	$41.00
Subtotal			$41.00 0
Grand Total
Total			$41.00
Payment 08/02/2019			$41.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Brian Humpal - 08/02/2019 4:27 PM eebb58ebd0a4c4a33a2e9aff0f623156 ad51ae7c1371a6018a7362201856da6e
#1 Compliance Inspection Accepted	Paul O'Neel - 08/16/2019 9:30 AM 4505ce920760e464ad0d037d25be6348 8c187d85d9059330c6628022008ee05f

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:	08/15/2019: Under review. PMO
File(s):

Create Letter

Compliance Letter Type:	Imminent Threat, Abatement Notice and Order	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: