Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2662, Submission # Submission-2021-2841, UID # 34087
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/01/2021 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
170292043001213682 30TH STREET CIR N, TOWN OF BAYTOWN1368230TH STREETCIRNSTILLWATERTOWN OF BAYTOWN55082SOVELL RAGAN & JOSHUA PEDERSEN101COBBLESTONE ACRES1972
Owner's representative:
Name:
Brad Kirtz
Phone:
(612207 - 5904
Email:
brad.kirtz@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
Homeowner testimony (See Comments/Explanation)

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: 06/08/2021

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: 2 Decimal Feet
B. Periodically saturated soil/bedrock: 5.3 Decimal Feet
C. System separation: 3.3 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

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
David R. BrownL3649651-788-3296PO Box 251026 Woodbury, MN 55125NoNoNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: drufusb1@yahoo.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 #6874 (06/08/2021)

Charge Cost Quantity Total
Non-Taxable
added 06/08/2021 9:25 PM

$47 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 06/08/2021$42.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantDavid R. Brown - 07/10/2021 8:03 AM
cd1983f10d0f162f862fe209ed3aed66
73ec092de381e0ef874b29892120bca8
 
#1 Compliance Inspection AcceptedSarah Borrell - 07/10/2021 10:26 AM
d636d45237a6ff056972d6e7791cf46b
2938bd8c2025e97cbeb2cee9b0144152
 
Inspection has been approved. All signatures have been obtained.
Text:
Property within a shoreland protection area.
File(s):
    Text:
    Shoreland area? Pg. 12 is inspector boring (see permit). Inspector responded to email & will amend.
    File(s):
    Compliance Letter Type: Certificate of Compliance Who's signature should be on the letter? Sarah Borrell Permit number to reference in "No Replace" letter:
    Was the letter sent? Yes Compliant/Non-Compliant: Compliant
    Certificate of Compliance:
      Letter of Non-Compliance:
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