Compliance Inspection Compliance Inspection Compliance Inspection # CI-2020-2039, Submission # Submission-2020-2136, UID # 26340
Status: Compliance Inspection Accepted
 

System Status

System status on date: 12/27/2019 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
320272144000212085 GREY CLOUD TRL S, CITY OF COTTAGE GROVE12085GREY CLOUDTRLSCOTTAGE GROVECITY OF COTTAGE GROVE55016GILBERSTADT TERRYL S & DAVID C1959
Property Owner's Mailing Address
(if different than property address):
2815 Dodd Rd
Suite 101
Egan MN 55121
Owner's representative:
Name:
Patty Bestler
Phone:
(612214 - 8577
Email:
patty.bestler@aggregate-us.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
Homeowner testimony (See Comments/Explanation)
Comments/Explanation:
renter said there have never been any issues with backups or ponding in yard

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
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
dropped underwater camera in and no cracks observed, and at operating level.  Baffles intact as well.

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: No

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.:
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)
Comments/Explanation:
See boring log and report attached
A. Bottom of distribution media: 94.1 Decimal Feet
B. Periodically saturated soil/bedrock: 91.1 Decimal Feet
C. System separation: 3 Decimal Feet
D. Required compliance separation: 3 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

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Ten Thirty Environmental Solutions, SBCL4082612-248-42811684 132nd Ave NE Blaine, MN 55449NoNoYesYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: alex.pepin@tenthirtyenvironmental.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 #5139 (01/02/2020)

Charge Cost Quantity Total
Non-Taxable
added 01/02/2020 12:44 PM

$41 Flat Fee

$41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 01/02/2020$41.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantAlex Pepin - 01/02/2020 12:44 PM
98f259275059fb254a957d40efc9ee6e
409908b0fe27f8e0bc52f1a31c9630c9
 
#1 Compliance Inspection AcceptedDenise Lange - 01/03/2020 11:11 AM
13dbc75ffbf45972d6991dabd6dcf3bb
8fe62164fe37f0046ff7cf050f3660da
 
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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