Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2523, Submission # Submission-2021-2698, UID # 33235
Status: System Replaced
 

System Status

System status on date: 04/01/2021 System Status: Noncompliant

System - Noncompliant

Reason(s) for noncompliance:
Tank Integrity (Compliance Component #2) - Failing to protect groundwater

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
350322142000218330 IVYWOOD AVE N, CITY OF FOREST LAKE18330IVYWOODAVENFOREST LAKECITY OF FOREST LAKE55025MANCINI ROBERT JR & SAMANTHA1976
Owner's representative:
Name:
Carl Keller
Phone:
(612919 - 3704
Email:
kellerprop99@aol.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:
Yes
: second
Verification method(s):
Examined empty (pumped) tank(s)
Comments/Explanation:
ROOTS IN SECOND 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
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: 08/23/2003

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.:
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: -2 Decimal Feet
B. Periodically saturated soil/bedrock: 1 Decimal Feet
C. System separation: 3 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

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Lashinski SepticL65763-434-39151244 Crosstown Blvd NE Ham Lake, MN 55304NoNoNoNoNo
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: rlashinski@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 #6574 (04/01/2021)

Charge Cost Quantity Total
Non-Taxable
added 04/01/2021 7:39 AM

$47 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 07/19/2021$42.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantRyan E. Lashinski - 04/01/2021 7:39 AM
af85ca8a12277742bf69a1036f473f61
43e6c3aaf97700d8909b348ecc319cbd
 
#1 Compliance Inspection AcceptedTyler Dale - 04/28/2021 1:48 PM
17d8debafcab8086de93706aa8e66d41
09000a388fd914f5d70388977a7edf34
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    File(s):
      Compliance Letter Type: Failed System, Notice and Order to Comply, Cesspool 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
      Certificate of Compliance:
        Letter of Non-Compliance:
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