SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2022-2986, Submission # Submission-2022-3193, UID # 38945
Status: System Replaced
Status: System Replaced
System Status
System status on date: | 01/21/2022 | System Status: | Noncompliant |
System - Noncompliant
Reason(s) for noncompliance: | Tank Integrity (Compliance Component #2) - Failing to protect groundwater |
Property Information
Property Information: | |||||||||||||||||
Owner's representative: |
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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: | See Report |
Tank Integrity
System consists of seepage pit, cesspool, drywell, or leaching pit: |
Yes |
Sewage tank(s) leak below their designed operating depth: |
Yes |
: | All |
Verification method(s): | Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | See 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 |
Explain: | See Report |
System is non protective of groundwater for other conditions as determined by the inspector: |
No |
Explain: | See Report |
Date of Install
Date of install known: | No |
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.: |
No |
Drainfield meets the designed vertical separation distance from periodically saturated soil or bedrock.: |
No |
Verification method(s): | Not applicable (Holding tank(s), no drainfield) |
Comments/Explanation: | See Report |
A. Bottom of distribution media: | 0 Decimal Feet |
B. Periodically saturated soil/bedrock: | 0 Decimal Feet |
C. System separation: | 0 Decimal Feet |
D. Required compliance separation: | 0 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 Report |
Attach Files: |
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Certification
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: | brian@midwestsoiltesting.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 #7702 (01/28/2022)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 01/28/2022 2:28 PM $47 Flat Fee |
$44.00 | x 1 | $44.00 |
Grand Total | |||
Total | $44.00 | ||
Payment 02/01/2022 | $44.00 | ||
Due | $0.00 |
Approvals
Approval | Signature |
---|---|
Applicant | Brian Humpal - 01/28/2022 2:28 PM 7e3272004b7899e5a6fcd308e32207ee 76ae5130bebe0b6a98d524063492cbb2 |
#1 Compliance Inspection Accepted | Sarah Borrell - 02/01/2022 11:16 AM d4ec3c3a3960702680f33be9f973000a 44ac7c4137bed01cef5d0d88e2fdf783 |
Inspection has been approved. All signatures have been obtained.
Public Notes
Text: | |
File(s): |
Internal Notes
Text: | |
File(s): |