Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2906, Submission # Submission-2021-3064, UID # 36690
Status: Compliance Inspection Accepted
 

System Status

System status on date: 09/28/2021 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
350272113001411273 KINGSBOROUGH TRL S, CITY OF COTTAGE GROVE11273KINGSBOROUGHTRLSCOTTAGE GROVECITY OF COTTAGE GROVE55016HERNANDEZ MARSELENA114RIVER OAKS 2ND ADD1996
Owner's representative:
Name:
Rich Boyer
Phone:
(651214 - 4311
Email:
richboyerconcrete@comcast.net

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 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: 10/20/1995

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:
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: 2.6 Decimal Feet
B. Periodically saturated soil/bedrock: 5.7 Decimal Feet
C. System separation: 3.1 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 attached REVISED report for the final report.
Attach Files:

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 #7432 (10/01/2021)

Charge Cost Quantity Total
Non-Taxable
added 10/01/2021 8:44 AM

$47 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 10/01/2021$42.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantDavid R. Brown - 10/01/2021 8:44 AM
a97000bcacaa850a31c2e9ae72f6483d
ce3e0ec079738fb1478308afabfc0dc2
 
#1 Compliance Inspection AcceptedSarah Borrell - 11/23/2021 3:52 PM
607617e5b2dbf4175a61fac3832e50d3
9ad127afd5eb1e876926eb8ef67e1f2b
 
Inspection has been approved. All signatures have been obtained.
Text:
See attached revised report.
File(s):
Text:
Confirmation Number: 3815128839
County managed SSTS program as of 1999.

11/16- Dave discussed with City if Shoreland or not, he will revise the report per that conversation and submit on 11/19. Spoke with HO 10/6. When Dave came out to do the design, he did a soil boring and said there was not a separation issue. Provided Ho with disagreement process.
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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