SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2020-2079, Submission # Submission-2020-2179, UID # 27082
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 02/27/2020 | System Status: | Compliant |
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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[ 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) |
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: | 04/26/1986 |
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: | 895.5 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 892.8 Decimal Feet |
| C. System separation: | 2.7 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: |
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existing_ssts_inspection_form.pdfCertification
| Inspector: |
Please search for and choose SELF/OTHER if what you need does not appear in the list
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| Inspector Email Address: | pbbrandt@soilinvestigations.us |
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 #5290 (03/02/2020)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 03/02/2020 10:23 AM $41 Flat Fee |
$41.00 | x 1 | $41.00 |
| Grand Total | |||
| Total | $41.00 | ||
| Payment 03/02/2020 | $41.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Paul J. Brandt - 03/02/2020 10:23 AM d9b058992937d6357adc8479824b147d 53fcbc4310a704b08c76b1febc767d89 | |
| #1 Compliance Inspection Accepted | Denise Lange - 03/02/2020 1:09 PM 2503c79ea78726f30980b9ced391fa22 a9a54123456a0b88026a9c9de6ab8ee5 |
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: |