SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2022-3301, Submission # Submission-2022-3513, UID # 42471
Status: System Replaced

System Status

System status on date:

05/06/2022

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
			0703121240001	4652 165TH ST N, CITY OF HUGO	4652	165TH	ST	N	HUGO	CITY OF HUGO	55038	COMBS DUSTIN & MOLLY				1935	No

Owner's representative:

Name:

Kathy Welch

Phone:

(651

) 357

- 8178

Email:

kathywelch10@hotmail.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 Searched for seeping in yard/backup into home Homeowner testimony (See Comments/Explanation)	Comments/Explanation:	See attached 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):	Examined empty (pumped) tank(s)
Comments/Explanation:	See attached 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 attached report.
System is non protective of groundwater for other conditions as determined by the inspector:	No

Date of Install

Date of install known:

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)
A. Bottom of distribution media:	97.5 Decimal Feet
B. Periodically saturated soil/bedrock:	100 Decimal Feet
C. System separation:	-2.5 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:

File 1: Welch_Outbuilding_Inspection.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
Zierke Soil Testing, LLC	L119	651-249-1346	28587 Jeffrey Ave Chisago City, MN 55013	No	No	No	Yes	Yes

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

Inspector Email Address:

benzierke@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 #8443 (08/25/2022)

Charge	Cost	Quantity	Total
Non-Taxable
2025 Compliance Inspection Fee added 08/25/2022 7:03 AM $47 Flat Fee	$44.00	x 1	$44.00
Subtotal			$44.00 0
Grand Total
Total			$44.00
Payment 08/25/2022			$44.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Benjamin J. Zierke - 08/25/2022 7:03 AM b975fedb4c8f75bc77b28338aaaafec9 44e5135652ca2841117f0abf9a9f3ff4
#1 Compliance Inspection Accepted	Tyler Dale - 09/16/2022 11:14 AM fe3871fbb59fa83f58b033db6e1188a2 557219091157377085af9862bdfae14d

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:
File(s):

Create Letter

Compliance Letter Type:	Imminent Threat, Abatement Notice and Order	Who's signature should be on the letter?	Tyler Dale	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: