Compliance Inspection Compliance Inspection Compliance Inspection # CI-2023-3476, Submission # Submission-2023-3681, UID # 45571
Status: Compliance Inspection Accepted
 

System Status

System status on date: 04/11/2023 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
20029201300122655 NORTHRIDGE LN N, TOWN OF WEST LAKELAND2655NORTHRIDGELNNSTILLWATERTOWN OF WEST LAKELAND55082WOJTOWICZ GUY & JODELL23HIDDEN MEADOW ESTATES1992
Owner's representative:
Name:
Jody Wojtowicz
Phone:
(651234 - 5550
Email:
sssepticsolutions@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):
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 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: 06/01/1992

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging? No
Drainfield has at least a two-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)
Comments/Explanation:
Recommended to the homeowner to clear the trees and brush off the STA
A. Bottom of distribution media: 2.5 Decimal Feet
B. Periodically saturated soil/bedrock: 5.5 Decimal Feet
C. System separation: 3 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

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
SS Septic Solutions LLCL4137651-343-911714845 113th St S Hastings, MN 55033NoYesNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: sssepticsolutions@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 #8987 (04/16/2023)

Charge Cost Quantity Total
Non-Taxable
added 04/16/2023 2:26 PM

$47 Flat Fee

$45.00 x 1 $45.00
Grand Total
Total $45.00
Payment 04/16/2023$45.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantShelley L. Schlomka - 04/16/2023 2:26 PM
62a7fce7c704b313cad48edb90c189ec
421828d4eed0d46315b34e85787f3902
 
#1 Compliance Inspection AcceptedSarah Borrell - 05/13/2023 4:49 AM
41f4b775957af6774f9c08ffe3b00c45
55e7a642716095fad71e85139792b6c1
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    Rock Fragment not compliance criteria alone per 7080.1500 Subp. 4. Grab sample of well included
    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:
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