Compliance Inspection Compliance Inspection Compliance Inspection # CI-2023-3547, Submission # Submission-2023-3768, UID # 46789
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/06/2023 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
160322044000321207 NEWBERRY AVE N, CITY OF SCANDIA21207NEWBERRYAVENSCANDIACITY OF SCANDIA55073PERRY WILLIAM N & TERRI J HARRISON-PERRY13NATURES WALK1981
Owner's representative:
Name:
Rhen and Brittany Gainsley
Phone:
(651491 - 4352
Email:
rhennicholas@yahoo.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 Tank Integrity Form (Attach)
Comments/Explanation:
See attached report.

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: 11/15/2007

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: 101 Decimal Feet
B. Periodically saturated soil/bedrock: 98.2 Decimal Feet
C. System separation: 2.8 Decimal Feet
D. Required compliance separation: 2.55 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
Zierke Soil Testing, LLCL119651-249-134628587 Jeffrey Ave Chisago City, MN 55013NoNoNoYesYes
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 #9198 (06/18/2023)

Charge Cost Quantity Total
Non-Taxable
added 06/18/2023 9:09 PM

$47 Flat Fee

$45.00 x 1 $45.00
Grand Total
Total $45.00
Payment 06/18/2023$45.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantBenjamin J. Zierke - 06/18/2023 9:09 PM
e3cae7062d47c765f3b5de6b7c27003d
91c6fffa1cc04e3bc4c5e3acc1d11cff
 
#1 Compliance Inspection AcceptedSarah Borrell - 07/10/2023 3:37 PM
f78bd4c1b982284e4db0785524d74ab9
1dcf99ee6f4fc62dfbd54bba802a9204
 
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? 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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