SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2489, Submission # Submission-2021-2681, UID # 32916
Status: System Replaced

System Status

System status on date:

03/09/2021

System Status:

Noncompliant

System - Noncompliant

Reason(s) for noncompliance:

Soil Separation (Compliance Component #4) - Failing to protect groundwater

Property Information

Property Information:

Compliance Status		Property Record		Property Address								Property Owner	Property Attributes
Compliance Expiration	Compliance Status	Parent GeoCode	PIN	Site Address	Building Number	Street Name	Type	Dir	City	Municipality	zip	Owner	Lot	Block	Plat	Year Built	Property Hold
			0603219310010	23303 QUENTIN AVE N, CITY OF SCANDIA	23303	QUENTIN	AVE	N	SCANDIA	CITY OF SCANDIA	55073	SPIEGEL RONALD	E		RLS #87	1977

Owner's representative:

Name:

Paul Clark

Phone:

(123

) 456

- 7890

Email:

noemail@noemail.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):	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):	Examined Tank Integrity Form (Attach)
Comments/Explanation:	Although not a compliance criteria, it should be noted that there is root infiltration into the septic tank

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:	No
Explain:	See Report

Date of Install

Date of install known:	Yes
Date of installation:	01/01/1977

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging?	Yes
Drainfield has at least a two-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:	2.9 Decimal Feet
B. Periodically saturated soil/bedrock:	3.25 Decimal Feet
C. System separation:	0.33 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

Comments or recommendations:	See Report
Attach Files:	File 1: 23303_Quentin_Ave_N.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
Midwest Sewer Services	L2896	651-492-7550	6616 Indian Wells Trail Grant, MN 55110	Yes	Yes	Yes	Yes	Yes

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 #6511 (03/15/2021)

Charge	Cost	Quantity	Total
Non-Taxable
2025 Compliance Inspection Fee added 03/15/2021 1:34 PM $47 Flat Fee	$42.00	x 1	$42.00
Subtotal			$42.00 0
Grand Total
Total			$42.00
Payment 03/19/2021			$42.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Brian Humpal - 03/15/2021 1:34 PM 548a2c9fc9a679b77c96987bf79383e6 032ee02326a86917c324180233ce0278
#1 Compliance Inspection Accepted	Tyler Dale - 04/05/2021 10:26 AM 2a713ef1c1f8a6a20a3ac71aeb01e67d 82a5a664a48a546cbbb57be7ee9f6a3c

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:
File(s):

Create Letter

Compliance Letter Type:	Failed System, Notice and Order to Comply, Separation	Who's signature should be on the letter?	Tyler Dale	Permit number to reference in "No Replace" letter:
Was the letter sent?	Yes	Compliant/Non-Compliant:	Noncompliant

Letter of Compliance

Certificate of Compliance:

Letter of Non-Compliance

Letter of Non-Compliance: