SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2023-3646, Submission # Submission-2023-3868, UID # 48129
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
System status on date: | 08/25/2023 | System Status: | Compliant |
Property Information
Property Information: | |||||||||||||||||
Owner's representative: |
|
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 Excessive ponding in soil system/D-boxes |
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 construction records Examined Tank Integrity Form (Attach) |
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: | 08/14/2002 |
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): | Conducted soil observation(s) (Attach boring logs) Two previous verifications (Attach boring logs) |
A. Bottom of distribution media: | 101.2 Decimal Feet |
B. Periodically saturated soil/bedrock: | 98.2 Decimal Feet |
C. System separation: | 3 Decimal Feet |
D. Required compliance separation: | 3 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: |
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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: | tomtrooien@aol.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 #9484 (08/25/2023)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 08/25/2023 3:22 PM $47 Flat Fee |
$45.00 | x 1 | $45.00 |
Grand Total | |||
Total | $45.00 | ||
Payment 08/25/2023 | $45.00 | ||
Due | $0.00 |
Action: Print
Approvals
Approval | Signature | Options |
---|---|---|
Applicant | Tom Trooien - 08/25/2023 3:22 PM 9a310d857863204d649b025aefcbb16e b2a947d6ce129ef56625ba32d56f2152 | |
#1 Compliance Inspection Accepted | Sarah Borrell - 09/27/2023 10:49 AM 88c8cbfa58c3fa3c7b3b732301847e25 5db8bd019f642d36590525e9be82cf73 |
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: |