SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0220, Submission # Submission-2016-0197, UID # 2362
Status: System Replaced
Status: System Replaced
System Status
System status on date: | 05/27/2016 | System Status: | Noncompliant |
System - Noncompliant
Reason(s) for noncompliance: | Soil Separation (Compliance Component #4) - Failing to protect groundwater |
Property Information
Property Information: | |||||||||||||||||
Property Owner's Mailing Address (if different than property address): |
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Owner's representative: |
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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): | Probed tank(s) bottom Examined construction records |
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: | 05/27/1981 |
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: |
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) |
A. Bottom of distribution media: | 24 Decimal Feet |
B. Periodically saturated soil/bedrock: | 36 Decimal Feet |
C. System separation: | 0 Decimal Feet |
D. Required compliance separation: | 24 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: | 1200 gallon tank, 3 trenches |
Attach Files: |
Certification
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 #907 (05/27/2016)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 05/27/2016 12:32 PM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
Grand Total | |||
Total | $40.00 | ||
Payment 06/17/2016 | $40.00 | ||
Due | $0.00 |
Action: Print
Approvals
Approval | Signature | Options |
---|---|---|
Applicant | Chad Lashinksi - 06/17/2016 10:21 AM - witnessed by Kati Hallermann e849c6894dc462e6c022ebb6298de77f eb407ead127803f2a935fc05009ef523 | |
#1 Compliance Inspection Accepted | Christopher W. LeClair REHS - 06/27/2016 9:46 AM f821f2efd6efedb2aa85e73abc7d5cd0 8dde1d575639da4d2bee98a05afb3de0 |
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: |
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