Compliance Inspection Compliance Inspection Compliance Inspection # CI-2023-3440, Submission # Submission-2023-3650, UID # 44821
Status: System Replaced
 

System Status

System status on date: 12/19/2022 System Status: Noncompliant

System - Noncompliant

Reason(s) for noncompliance:
Tank Integrity (Compliance Component #2) - Failing to protect groundwater

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
0202820430010921 QUENTIN AVE S, CITY OF LAKELAND921QUENTINAVESLAKELANDCITY OF LAKELAND55043RUDD AZURA & JAMES RILEY1930No
Owner's representative:
Name:
James Riley
Phone:
(111111 - 1111
Email:
jr.riley.95@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):
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
Visual Inspection of the area. No signs of sewage to the ground surface. The homeowners did not report back-ups in the house.

Tank Integrity

System consists of seepage pit,
cesspool, drywell, or leaching pit:
Yes
Sewage tank(s) leak below their
designed operating depth:
No
Verification method(s):
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
Tank not pumped after investigation of tanks.The tanks are cesspools without a drainfield and must be replaced with water tight tanks with a drainfield.

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
Explain:
Inspected area around tanks.

Date of Install

Date of install known: No

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging? Yes
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):
Other (See Comments/Explanation)
Comments/Explanation:
No drainfield.
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

Comments or recommendations:
See attached file
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
SELF/OTHERn/an/an/a
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): Jesse Kloeppner
Inspector Email Address: jesse@ksd-mn.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 #8820 (02/13/2023)

Charge Cost Quantity Total
Non-Taxable
added 02/13/2023 8:36 PM

$47 Flat Fee

$45.00 x 1 $45.00
Grand Total
Total $45.00
Payment 02/13/2023$45.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantJesse J. Kloeppner - 02/13/2023 8:36 PM
63a8c60e2708a161215309c0f2c10283
3788f07e87f1a3e37e6a9d671cdc712e
 
#1 Compliance Inspection AcceptedSarah Borrell - 02/17/2023 11:32 AM
35a565ba4c20bfca025b5f7938803375
4479e33ae06b3a5c21769390bbd2320d
 
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:
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