SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2801, Submission # Submission-2021-3006, UID # 35673
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 08/30/2021 | System Status: | Compliant |
Property Information
| Property Information: | |||||||||||||||||
| Owner's representative: |
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[ Search Result Limit: 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 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 empty (pumped) tank(s) |
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: | 10/05/2002 |
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): | Conducted soil observation(s) (Attach boring logs) |
| Comments/Explanation: | Mound with 1ft build |
| A. Bottom of distribution media: | 1 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 2 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
| Attach Files: |
Jau_Vandermyde_Comp_Cover21.pdfCertification
| Inspector: |
Please search for and choose SELF/OTHER if what you need does not appear in the list
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| Inspector Contact (If 'self/other' is selected from the Inspector Lookup): | Danielle Lang |
| Inspector Email Address: | mjlcontract@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 #7238 (08/30/2021)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 08/30/2021 10:29 AM $47 Flat Fee |
$42.00 | x 1 | $42.00 |
| Grand Total | |||
| Total | $42.00 | ||
| Payment 08/30/2021 | $42.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Danielle Lang - 08/30/2021 10:29 AM 6bccf12676d40e710e790fba64de6364 e1391434cf5d7a0403a6eb51727b3411 | |
| #1 Compliance Inspection Accepted | Sarah Borrell - 09/10/2021 12:02 PM 1ced4d5cfd01970de5af810eb2ac210b c47def31198b71543ef391dbf92f92fa |
Inspection has been approved. All signatures have been obtained.
| Text: | |
| File(s): |
| Text: | |
| 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: |