SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2022-3351, Submission # Submission-2022-3561, UID # 43250
Status: System Replaced
Status: System Replaced
System Status
System status on date: | 09/26/2022 | System Status: | Noncompliant |
System - Noncompliant
Reason(s) for noncompliance: | Tank Integrity (Compliance Component #2) - Failing to protect groundwater Other Compliance Conditions (Compliance Component #3) - Failing to protect groundwater |
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): | Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | Searched Yard |
Tank Integrity
System consists of seepage pit, cesspool, drywell, or leaching pit: |
Yes |
Sewage tank(s) leak below their designed operating depth: |
Yes |
Verification method(s): | Examined Tank Integrity Form (Attach) Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | tank has no bottom |
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: |
Yes |
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): | Other (See Comments/Explanation) |
Comments/Explanation: | System has no drain field |
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
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): | Voight |
Inspector Email Address: | noemail@noemail.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 #8562 (10/03/2022)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 10/03/2022 2:51 PM $47 Flat Fee |
$44.00 | x 1 | $44.00 |
Grand Total | |||
Total | $44.00 | ||
Payment 09/30/2022 | $44.00 | ||
Due | $0.00 |
Action: Print
Approvals
Approval | Signature | Options |
---|---|---|
Applicant | Daniel Voight - 10/28/2022 2:34 PM - witnessed by Sarah Borrell f9b101f10cd3066dc42f3590497e2612 274b8e0a06d2700bf3724a216c220571 | |
#1 Compliance Inspection Accepted | Sarah Borrell - 10/28/2022 2:34 PM 0417c53e3f8a4487198134aecdb7dcf8 3388106ade1b02d7f07f8061b64b1a22 |
Inspection has been approved. All signatures have been obtained.
Text: | |
File(s): |
Text: | |
File(s): |
Compliance Letter Type: | Failed System, Notice and Order to Comply, Separation | 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 |
Certificate of Compliance: |
Letter of Non-Compliance: |