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Compliance Inspection Compliance Inspection UID # 47305
Status: In Progress
 

System Status

System status on date: 07/14/2023 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
330302044003014949 62ND ST N, CITY OF STILLWATER1494962NDSTNSTILLWATERCITY OF STILLWATER55082WASHINGTON COUNTY
Property Owner's Mailing Address
(if different than property address):
TEST
TEST MN 55021
Owner's representative:
Name:
Rice County System Test
Phone:
(507) 332 - 6113
Email:
laurie.johnson@ricecountymn.gov

Impact on Public Health

System discharges sewage to
the ground surface:		 System discharges sewage to
drain tile or surface waters:		 System causes sewage backup
into dwelling or establishment:
Verification method(s): Comments/Explanation: 







	





	
Tank Integrity

	


System consists of seepage pit,
 cesspool, drywell, or leaching pit:		




Sewage tank(s) leak below their
 designed operating depth:		




 :




Verification method(s):




Comments/Explanation:








	





	
Other Compliance Conditions

	


Maintenance hole covers are damaged, cracked,
 unsecured, or appear to be structurally unsound:		




Other issues (electrical hazards, etc.) to
 immediately and adversely impact public
 health or safety:		




Explain:





System is non protective of groundwater for other
 conditions as determined by the inspector:		




Explain:








	





	
Date of Install

	


Date of install known:




Date of installation:







	





	
Soil Separation

	


Shoreland/Wellhead Protection/Food, beverage, lodging?




Drainfield has at least a two-foot vertical separation
 distance from periodically saturated soil or bedrock:		




Drainfield has at least a three-foot vertical separation
 distance from periodically saturated soil or bedrock.:		




Drainfield meets the designed vertical separation
 distance from periodically saturated soil or bedrock.:		




Verification method(s):




Comments/Explanation:





A. Bottom of distribution media:
 Decimal Feet



B. Periodically saturated soil/bedrock:
 Decimal Feet



C. System separation:
 Decimal Feet



D. Required compliance separation:
 Decimal Feet






	





	
Operating Permit and Nitrogen BMP

	


Is system operating under an Operating Permit:




Is the system required to employ Nitrogen BMP:







	





	
Comments and File Attachments

	


Comments or recommendations:





Attach Files:

    		

    

    

    
	
    

    

    
	
    Certification
    
	
    

    Inspector:


    
	
	
	
	
    None
    

    

    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):


    

    Inspector Email Address:


    

    

    
	
    

    

    
	
    Invoice #9296 (07/14/2023)
    
	
    

    


    
	
	Charge
	Cost
	Quantity
	Total
	

    

    
	Grand Total

    
	Total
	$0.00

    Due$0.00
    This Application has not been submitted, so you may not pay for this Invoice.
    Action: Print  
    


    
	
    

    

    

    


    

    Text:

    		

    

    File(s):

      		

      

      

      

      

      


      

      Text:

      		

      

      File(s):

        		

        

        

        

        

        


        

        Compliance Letter Type:

Who's signature should be on the letter?

Permit number to reference in "No Replace" letter:


        

        Was the letter sent?

Compliant/Non-Compliant:


        

        

        

        

        


        

        Certificate of Compliance:

          		

          

          

          

          

          


          

          Letter of Non-Compliance:

            		

            

            

            

            

            


            

		
            
		
		
            

            
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