SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2927, Submission # Submission-2021-3131, UID # 37845
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 11/19/2021 | 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 surface outlet Searched for seeping in yard/backup into home Homeowner testimony (See Comments/Explanation) |
Comments/Explanation: | See attached report. |
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) |
| Comments/Explanation: | See attached report. |
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: | 01/01/1984 |
Soil Separation
| Shoreland/Wellhead Protection/Food, beverage, lodging? | No |
| 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: | 96.9 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 94.9 Decimal Feet |
| C. System separation: | 2 Decimal Feet |
| D. Required compliance separation: | 2 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: |
Seiberlich_Inspection_11-19-21.pdfCertification
| Inspector: |
Please search for and choose SELF/OTHER if what you need does not appear in the list
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| Inspector Email Address: | benzierke@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 #7588 (11/22/2021)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 11/22/2021 1:51 PM $47 Flat Fee |
$42.00 | x 1 | $42.00 |
| Grand Total | |||
| Total | $42.00 | ||
| Payment 11/22/2021 | $42.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Benjamin J. Zierke - 11/22/2021 1:52 PM 309ca9cba167a742abacc091e01fdd1a f1a2b58b5ab85defd384d554a8ebf710 | |
| #1 Compliance Inspection Accepted | Sarah Borrell - 12/08/2021 9:30 AM 311cbba006d95d3c9762e57af8662589 116dbbafbdb715189e328fdda6240c59 |
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: |