Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0197, Submission # Submission-2016-0210, UID # 2845
Status: Compliance Inspection Accepted
 

System Status

System status on date: 04/29/2016 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
07027212100096360 GOODVIEW BAY S, CITY OF COTTAGE GROVE6360GOODVIEW BAYSCOTTAGE GROVECITY OF COTTAGE GROVE55016PROKOP JUSTIN & KRISTIN61ACORN RIDGE2006
Property Owner's Mailing Address
(if different than property address):
14523 SW Miliakan Way #200
Beaverton OR 97005
Owner's representative:
Name:
Sarah Burke
Phone:
(763226 - 9573
Email:
sburke@bchrealty.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

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 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: 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.:
Yes
Verification method(s):
Conducted soil observation(s) (Attach boring logs)
A. Bottom of distribution media: 30 Decimal Feet
B. Periodically saturated soil/bedrock: 66 Decimal Feet
C. System separation: 36 Decimal Feet
D. Required compliance separation: 36 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:
Septic & Pump tanks w/trench treatment (Chambers) 
Attach Files:

Certification

Inspector:
Name:
Jerry Sauber
MPCA License #:
L317
Business Name:
Sauber P& H Co
Phone:
(651463 - 7434
Email:
septic@co.washington.mn.us
Address:
100 third St
Farmington MN 55024

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 #919 (06/02/2016)

Charge Cost Quantity Total
Grand Total
Total $0.00
Payment 05/04/2016$0.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantJerry Sauber - 06/13/2016 1:30 PM - witnessed by Kati Hallermann
ad483ed2f906c4db564c276526aed4a0
46b74279c6e2f50c00e2e46afbb88a27
 
#1 Compliance Inspection AcceptedKati Hallermann - 06/13/2016 1:30 PM
f385b8e11c4a107640c108319af94a7d
d9e390ffb62d088ae4a35fd88e478eef
 
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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