SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2022-3174, Submission # Submission-2022-3389, UID # 41110
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
System status on date: | 06/08/2022 | System Status: | Compliant |
Property Information
Property Information: | |||||||||||||||||
Owner's representative: |
|
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 |
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 construction records Examined Tank Integrity Form (Attach) Examined empty (pumped) tank(s) |
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: | 09/27/2004 |
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.: |
Yes |
Verification method(s): | Conducted soil observation(s) (Attach boring logs) Two previous verifications (Attach boring logs) |
A. Bottom of distribution media: | 102.18 Decimal Feet |
B. Periodically saturated soil/bedrock: | 99.08 Decimal Feet |
C. System separation: | 3.1 Decimal Feet |
D. Required compliance separation: | 3 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: |
Certification
Inspector: |
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): | Jeffrey Peterson |
Inspector Email Address: | sewerworks@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 #8167 (06/10/2022)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 06/10/2022 5:38 PM $47 Flat Fee |
$44.00 | x 1 | $44.00 |
Grand Total | |||
Total | $44.00 | ||
Payment 06/10/2022 | $44.00 | ||
Due | $0.00 |
Action: Print
Approvals
Approval | Signature | Options |
---|---|---|
Applicant | Jeffrey R. Peterson - 06/10/2022 5:38 PM bb45fd048bd5c42a53e80c2dee607d55 ba706d28f86be3cd71a65e07fa1a0a08 | |
#1 Compliance Inspection Accepted | Sarah Borrell - 07/01/2022 11:24 AM 25b14cab3b940a29bf7f39591affe15c 8024f3bfa99ee321fac8c234a3e351f1 |
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: |