SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2024-3790, Submission # Submission-2023-4020, UID # 48030
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
System status on date: | 08/16/2023 | System Status: | Compliant |
Property Information
Property Information: | |||||||||||||||||
Owner's representative: |
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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: | See 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): | Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | See 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 |
Explain: | See Report |
System is non protective of groundwater for other conditions as determined by the inspector: |
No |
Explain: | See Report |
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.: |
Yes |
Drainfield meets the designed vertical separation distance from periodically saturated soil or bedrock.: |
Yes |
Verification method(s): | Other (See Comments/Explanation) |
Comments/Explanation: | See Report |
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: | Borings 898-901 per Inspector 1/9/24 |
Attach Files: |
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Certification
Inspector: |
Please search for and choose SELF/OTHER if what you need does not appear in the list
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Inspector Email Address: | brian@midwestsoiltesting.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 #9474 (12/21/2023)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 12/21/2023 12:27 PM $47 Flat Fee |
$45.00 | x 1 | $45.00 |
Grand Total | |||
Total | $45.00 | ||
Payment 12/21/2023 | $45.00 | ||
Due | $0.00 |
Action: Print
Approvals
Approval | Signature | Options |
---|---|---|
Applicant | Brian Humpal - 12/21/2023 12:27 PM d95fa84cb9afc2870be8823be0beff0f 0fcdf85e8cfcb912b4b13d1c905bcdee | |
#1 Compliance Inspection Accepted | Sarah Borrell - 01/09/2024 11:12 AM 75c8c469e9f3f6d51bdb12894223b0ad 72f8be6c0d0096851201c0eda489c861 |
Inspection has been approved. All signatures have been obtained.
Text: | Borings 898-901 apply per Chris Uebe on 1/9/2024 |
File(s): |
Text: | (Inspector acknowledged this report was submitted late and it was not on purpose but due to health issues at that time) |
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: |