Compliance Inspection Compliance Inspection Submission # Submission-2020-2284, UID # 27762
Status: System Replaced
 

System Status

System status on date: 05/19/2020 System Status: Noncompliant

System - Noncompliant

Reason(s) for noncompliance:
Impact on Public Health (Compliance Component #1) - Imminent threat to public health and safety
Other Compliance Conditions (Compliance Component #3) - Failing to protect groundwater
Soil Separation (Compliance Component #4) - Failing to protect groundwater
Operating Permit/Monitoring Plan Requirements (Compliance Component #5) - Noncompliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
21029211300048685 27TH ST N, CITY OF LAKE ELMO868527THSTNLAKE ELMOCITY OF LAKE ELMO55042RATLIFF JEFFERY P & SARA A91TABLYN PARK1958No
Owner's representative:
Name:
Jean Lounsbury
Phone:
(123456 - 7890
Email:
noemail@noemail.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:
Yes
Verification method(s):
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
See Report

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:
See Report

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
Explain:
See Report
System is non protective of groundwater for other
conditions as determined by the inspector:
Yes
Explain:
See Report

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.:
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:
See Report
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

Comments or recommendations:
See Report
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Midwest Sewer ServicesL2896651-492-75506616 Indian Wells Trail Grant, MN 55110YesYesYesYesYes
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 #5508 (05/22/2020)

Charge Cost Quantity Total
Non-Taxable
added 05/22/2020 11:55 AM

$41 Flat Fee

$41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 05/22/2020$41.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantBrian Humpal - 05/22/2020 11:55 AM
c314532b1ccc19082cf600c8cf71962f
b0c3c038491c8bb83b96ffefd09d0f13
 
#1 Compliance Inspection Accepted 
Status must be Pending Review
Text:
File(s):
    Text:
    07-02-2020: Missed call from Jeff Ratliff. Jeff stated he is interested in purchasing property. I called at left a message at 3:00p.m. to give me call to discuss why SSTS failed. Jeff called me back at 3:04p.m. I explained to Jeff that SSTS at property is a Type IV which requires additional maintenance & cost. We discussed the possibility of salvaging current system. Jeff stated he has been in communication with J. Kloeppner about this issue. PMO
    File(s):
    Compliance Letter Type: Imminent Threat, Abatement Notice and Order Who's signature should be on the letter? Joe Sanders Permit number to reference in "No Replace" letter:
    Was the letter sent? Yes Compliant/Non-Compliant:
    Certificate of Compliance:
      Letter of Non-Compliance:
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