SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2899, Submission # Submission-2021-3099, UID # 37228
Status: Compliance Inspection Accepted

System Status

System status on date:

10/14/2021

System Status:

Compliant

Property Information

Property Information:

Compliance Status		Property Record		Property Address								Property Owner	Property Attributes
Compliance Expiration	Compliance Status	Parent GeoCode	PIN	Site Address	Building Number	Street Name	Type	Dir	City	Municipality	zip	Owner	Lot	Block	Plat	Year Built	Property Hold
			1402820140036	2446 RIVER RD S, CITY OF ST MARY'S POINT	2446	RIVER	RD	S	LAKELAND	CITY OF ST MARY'S POINT	55043	JOINT REV TRS OF SCOTT J POLLEI & ANN E HOUSER	599		LANE'S SUNSET BEACH	1925

Owner's representative:

Name:

Scott Pollei & Ann Houser

Phone:

(651

) 459

- 0162

Email:

scott.pollei@dunnlake.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 signs of sewage to the ground surface. The renter 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 systems components in good condition. Pump and alarm in working condition.

Date of Install

Date of install known:

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.:	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:	4 Decimal Feet
B. Periodically saturated soil/bedrock:	7 Decimal Feet
C. System separation:	3 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 boring log
Attach Files:	File 1: KSD_SSTS_INSPECTION_2446_River_Rd_S_Lakeland_VER_1.0_10-18-21.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
SELF/OTHER	n/a	n/a	n/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 #7514 (10/28/2021)

Charge	Cost	Quantity	Total
Non-Taxable
2025 Compliance Inspection Fee added 10/28/2021 11:22 AM $47 Flat Fee	$42.00	x 1	$42.00
Subtotal			$42.00 0
Grand Total
Total			$42.00
Payment 10/28/2021			$42.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Jesse J. Kloeppner - 10/28/2021 11:22 AM 8d978cd5ba048481cc76c4d09d243486 8116f25d2b2c45ad7b7296c623aa49f4
#1 Compliance Inspection Accepted	Sarah Borrell - 11/15/2021 10:49 AM 762f4ac47a92a449cee33091ab249c0a 9ea06b08734dfb98ea5b7ab9ae9ef031

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:
File(s):

Create Letter

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

Letter of Compliance

Certificate of Compliance:

Letter of Non-Compliance

Letter of Non-Compliance: