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Compliance Inspection Compliance Inspection Submission # Submission-2022-3358, UID # 40848
Status: Returned to Author
 

System Status

System status on date: 05/10/2022 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
360272131003211655 LAYTON AVE S, CITY OF COTTAGE GROVE11655LAYTONAVESHASTINGSCITY OF COTTAGE GROVE55033KENYON JEROLD & DANIELLEHRLS #831976
Property Owner's Mailing Address
(if different than property address):
11655 Layton Ave South
Hastings MN 55033
Owner's representative:
Name:
Angie Salonek
Phone:
(952) 873 - 3292
Email:
sewerservices.municipal@gmail.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):
Searched for surface outlet
 Comments/Explanation: 







	





	
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:








	





	
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:





System is non protective of groundwater for other
 conditions as determined by the inspector:		
No



Explain:








	





	
Date of Install

	


Date of install known:
Yes



Date of installation:
06/01/1997






	





	
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.:		
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 form




A. Bottom of distribution media:
40 Decimal Feet



B. Periodically saturated soil/bedrock:
80 Decimal Feet



C. System separation:
40 Decimal Feet



D. Required compliance separation:
36 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:





Attach Files:







	





	
Certification

	


Inspector:



	
	
	
	





NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector




Sewer Services, IncL2502952-873-329225648 200th St Belle Plaine, MN 56011YesYesNoYesYes









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):




Inspector Email Address:
sewerservices.cal@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 #8088 (05/23/2022)

	






	
	Charge
	Cost
	Quantity
	Total
	




	Non-Taxable


	
	 added 05/23/2022 1:55 PM
$47 Flat Fee

	$44.00
	 x 1
	$44.00
	


	Grand Total


	Total
	$44.00

Payment 05/23/2022$44.00
Due$0.00
This Application has not been submitted, so you may not pay for this Invoice.
Action: Print  




	











Text:





File(s):

    		

    

    

    

    

    


    

    Text:

    Called and left a vm at company's phone number above. Asked for site map and also let them know I could communicate via RT as they are the author - returned to author. Emailed Sewer Services on 12/23 for site map
    		

    

    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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