SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2019-1910, Submission # Submission-2019-1937, UID # 23229
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 08/09/2019 | System Status: | Compliant |
Property Information
| Property Information: | |||||||||||||||||
| Property Owner's Mailing Address (if different than property address): |
|
||||||||||||||||
| Owner's representative: |
|
||||||||||||||||
[
]
[ 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): | 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): | Examined Tank Integrity Form (Attach) |
| Comments/Explanation: | See attached tank integrity form from maintainer |
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: | 06/01/1986 |
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) |
| A. Bottom of distribution media: | 2 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 4 Decimal Feet |
| C. System separation: | 3 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: |
|
Scan0002.pdfCertification
| Inspector: |
Please search for and choose SELF/OTHER if what you need does not appear in the list
|
| Inspector Email Address: | sssepticsolutions@gmail.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 #4731 (08/15/2019)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 08/15/2019 6:48 PM $41 Flat Fee |
$41.00 | x 1 | $41.00 |
| Grand Total | |||
| Total | $41.00 | ||
| Payment 08/15/2019 | $41.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Shelley L. Schlomka - 09/14/2019 11:25 AM 1072628aebfbb92f7644fa381fc8eef2 c80ee97ecc1b9145260e0cd9675b05e3 | |
| #1 Compliance Inspection Accepted | Denise Lange - 09/17/2019 1:22 PM 86fd7f10a9b26bbe13f8ebcb7cc5e9c4 a642737c2ec44e5a23933fd9823c89ed |
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: |