SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0270, Submission # Submission-2016-0281, UID # 3909
Status: System Replaced
Status: System Replaced
System Status
| System status on date: | 06/23/2016 | System Status: | Noncompliant |
System - Noncompliant
| Reason(s) for noncompliance: | Impact on Public Health (Compliance Component #1) - Imminent threat to public health and safety Tank Integrity (Compliance Component #2) - Failing to protect groundwater Soil Separation (Compliance Component #4) - Failing to protect groundwater |
Property Information
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| 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: |
Yes |
| 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 |
| 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? | No |
| 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): | Conducted soil observation(s) (Attach boring logs) Other (See Comments/Explanation) |
| 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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5196_170th_Street_N.pdfCertification
| Inspector: |
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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 #1046 (07/01/2016)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 07/07/2016 10:18 AM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
| Grand Total | |||
| Total | $40.00 | ||
| Payment 07/12/2016 | $40.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Brian Humpal - 07/07/2016 10:18 AM 8522f359aedbb9e3a7e9d4434f4a8c5c 1eb61dc217519efee3057e3c2e7b942b | |
| #1 Compliance Inspection Accepted | Christopher W. LeClair REHS - 07/21/2016 8:28 AM 012fc05f717dbf33fb4ae77d7bd5425d 3a587db73fe56bf3d09ac7b18a505287 |
Inspection has been approved. All signatures have been obtained.
| Text: | |
| File(s): |
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| File(s): |
| Compliance Letter Type: | Who's signature should be on the letter? | Permit number to reference in "No Replace" letter: | |||
| Was the letter sent? | Compliant/Non-Compliant: |
| Certificate of Compliance: |
| Letter of Non-Compliance: |
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