Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2868, Submission # Submission-2021-3068, UID # 36712
Status: Compliance Inspection Accepted
 

System Status

System status on date: 09/29/2021 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
150302042000215625 95TH ST N, TOWN OF STILLWATER1562595THSTNSTILLWATERTOWN OF STILLWATER55082LISA A AFFELDT TRS11BELLE VIEW RIDGE2013
Owner's representative:
Name:
Daniel Affeldt
Phone:
(612270 - 9442
Email:
daniel.affeldt@affeldtsalestax.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:
Visual Inspection of the area.  No sign of sewage to the ground surface.  The owner did not report back-ups in to the house.

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):
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
Tanks pumped and visually inspected with camera.  No signs of cracks or leaking in any of the tanks.

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
Explain:
All system components in good condition.  Pump and alarm in working condition.

Date of Install

Date of install known: Yes
Date of installation: 07/10/2013

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.:
No
Verification method(s):
Conducted soil observation(s) (Attach boring logs)
Comments/Explanation:
See soil boring log and site map for location of boring, tanks and trenches.
A. Bottom of distribution media: 101.5 Decimal Feet
B. Periodically saturated soil/bedrock: 98.8 Decimal Feet
C. System separation: 2.7 Decimal Feet
D. Required compliance separation: 2.6 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 soil borings
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
SELF/OTHERn/an/an/a
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Contact (If 'self/other' is selected from the Inspector Lookup): Jesse Kloeppner
Inspector Email Address: jesse@ksd-mn.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 #7443 (10/04/2021)

Charge Cost Quantity Total
Non-Taxable
added 10/04/2021 10:40 AM

$47 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 10/04/2021$42.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantJesse J. Kloeppner - 10/04/2021 10:40 AM
10808b6a75b7e77acbc37e19cdb5f1d9
0a744fbca29d78493bd6b8ed8df2e51f
 
#1 Compliance Inspection AcceptedSarah Borrell - 10/07/2021 5:52 AM
3a9b7ae35eae85c9d76fcc62ef599089
9c959c9133f7548445fc2a857a91482b
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    Confirmation Number: 3815293480
    
    Compliance Inspection submitted with installation permit to alter existing system (building garage with sink, shower and toilet).
    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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