SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2022-3090, Submission # Submission-2022-3296, UID # 40553
Status: System Replaced

System Status

System status on date:

04/26/2022

System Status:

Noncompliant

System - Noncompliant

Reason(s) for noncompliance:

Impact on Public Health (Compliance Component #1) - Imminent threat to public health and safety

Other Compliance Conditions (Compliance Component #3) - Imminent threat to public health and safety

Soil Separation (Compliance Component #4) - Failing to protect groundwater

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
			3302721320006	8077 RIVER ACRES RD S, CITY OF COTTAGE GROVE	8077	RIVER ACRES	RD	S	COTTAGE GROVE	CITY OF COTTAGE GROVE	55016	CATURIA JOHN S & SANDRA J	7		HOUSE'S RIVER ACRES	1973

Owner's representative:

Name:

Susan Trevathan

Phone:

(123

) 456

- 7890

Email:

noemail@noemail.com

Impact on Public Health

System discharges sewage to the ground surface:	Yes	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:	No
Sewage tank(s) leak below their designed operating depth:	No
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:	Yes
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:

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):	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:	File 1: 8077_River_Acres_Rd.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
Midwest Sewer Services	L2896	651-492-7550	6616 Indian Wells Trail Grant, MN 55110	Yes	Yes	Yes	Yes	Yes

Please search for and choose SELF/OTHER if what you need does not appear in the list

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 #7961 (04/29/2022)

Charge	Cost	Quantity	Total
Non-Taxable
2025 Compliance Inspection Fee added 04/29/2022 11:20 AM $47 Flat Fee	$44.00	x 1	$44.00
Subtotal			$44.00 0
Grand Total
Total			$44.00
Payment 05/01/2022			$44.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Brian Humpal - 04/29/2022 11:20 AM 2b79cbd35189ffc19ce5767a4bcd6f5b a278828d76c8955b674f32abd4544393
#1 Compliance Inspection Accepted	Sarah Borrell - 05/06/2022 3:29 PM ce6bc987f7d0ca8358f071ee5f5a65cc ab5fa7d83ecae1bb79510bbc6129b876

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:	5/2 (SB) HO called with questions on timeline - see correspondence.
File(s):	File 1: 8077_River_Acres_Rd_S.msg

Create Letter

Compliance Letter Type:	Imminent Threat, Abatement Notice and Order	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:	Noncompliant

Letter of Compliance

Certificate of Compliance:

Letter of Non-Compliance

Letter of Non-Compliance: