Compliance Inspection Compliance Inspection Compliance Inspection # CI-2022-3308, Submission # Submission-2022-3520, UID # 42686
Status: Compliance Inspection Accepted
 

System Status

System status on date: 09/01/2022 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
020282021003181 QUANT CT S, CITY OF LAKELAND81QUANTCTSLAKELANDCITY OF LAKELAND55043MOLLENHAUER SERENA112ELMWOOD1976
Owner's representative:
Name:
Tom Trooien
Phone:
(651439 - 7323
Email:
tomtrooien@aol.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)

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 empty (pumped) tank(s)
Comments/Explanation:
The tank was at normal operating level then was pumped for the inspection. Lowered a camera into the empty tank - bottom, walls, cover, baffles, riser and maintenance hole cover ok

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: 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.:
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)
A. Bottom of distribution media: 3.5 Decimal Feet
B. Periodically saturated soil/bedrock: 5.7 Decimal Feet
C. System separation: 2.2 Decimal Feet
D. Required compliance separation: 2 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:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
All State Septic ServicesL1568651-439-732312155 Norell Ave N Stillwater, MN 55082NoNoNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: tomtrooien@aol.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 #8461 (09/01/2022)

Charge Cost Quantity Total
Non-Taxable
added 09/01/2022 10:43 AM

$47 Flat Fee

$44.00 x 1 $44.00
Grand Total
Total $44.00
Payment 09/01/2022$44.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantTom Trooien - 09/01/2022 10:44 AM
0e274ced036f889b8fa00b4eea061feb
90600af6464abacd0f4bce18317d5ea9
 
#1 Compliance Inspection AcceptedTyler Dale - 09/28/2022 2:21 PM
387b6a42b28206e60cc3eabdc305c64a
1485aac131bd689ad16d671763cdf8bb
 
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? Tyler Dale Permit number to reference in "No Replace" letter:
      Was the letter sent? Yes Compliant/Non-Compliant: Compliant
      Certificate of Compliance:
        Letter of Non-Compliance:
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