Compliance Inspection Compliance Inspection Compliance Inspection # CI-2020-2224, Submission # Submission-2020-2357, UID # 28737
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/26/2020 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
30029201300101635 NEWBERRY AVE N, TOWN OF WEST LAKELAND1635NEWBERRYAVENSTILLWATERTOWN OF WEST LAKELAND55082FUNK RYAN & RITA13EDEN VISTA2001
Property Owner's Mailing Address
(if different than property address):
386 Cannon View Dr
Red Wing MN 55066
Owner's representative:
Name:
Environmental Design Group
Phone:
(651341 - 6938
Email:
septicandwell@gmail.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 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: 01/15/2001

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging? Yes
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):
Two previous verifications (Attach boring logs)
A. Bottom of distribution media: 24 Decimal Feet
B. Periodically saturated soil/bedrock: 5 Decimal Feet
C. System separation: 36 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

Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Environmental Design Group IncL1955651-341-693830581 Wild Turkey Ct Frontenac, MN 55026NoNoYesYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: septicandwell@gmail.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 #5705 (06/28/2020)

Charge Cost Quantity Total
Non-Taxable
added 06/28/2020 4:00 PM

$41 Flat Fee

$41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 06/28/2020$41.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantEnvironmental D. Group - 06/28/2020 4:00 PM
a2f5296c6d70484b96a10fd3fc1a234c
76a0a34f8fa83d15cec68225e6e904a5
 
#1 Compliance Inspection AcceptedDenise Lange - 07/01/2020 8:37 AM
a8c25b3295a27e1aa520a2028f561502
8ac8783652f40c2ccc3a08acea0fe0af
 
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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