Compliance Inspection Compliance Inspection Compliance Inspection # CI-2023-3704, Submission # Submission-2023-3926, UID # 49130
Status: Compliance Inspection Accepted
 

System Status

System status on date: 10/05/2023 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
07031214100045261 165TH ST N, CITY OF HUGO5261165THSTNHUGOCITY OF HUGO55038JOLLY DREW J1964No
Owner's representative:
Name:
Drew Jolly
Phone:
(763434 - 3915
Email:
rlashinski@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

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: 02/11/2004

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: -2 Decimal Feet
B. Periodically saturated soil/bedrock: 1 Decimal Feet
C. System separation: 2.9 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:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Lashinski Service, Inc.L4266763-434-39151244 Crosstown Blvd NE Ham Lake, MN 55304YesYesYesYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: service@lashinskiseptic.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 #9619 (10/05/2023)

Charge Cost Quantity Total
Non-Taxable
added 10/05/2023 5:05 AM

$47 Flat Fee

$45.00 x 1 $45.00
Grand Total
Total $45.00
Payment 10/05/2023$45.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantRyan E. Lashinski - 10/05/2023 5:05 AM
e21e4eabe141cacc3b959365a73e65e7
29bf0eaa35c132ba3f189b88bac61d44
 
#1 Compliance Inspection AcceptedSarah Borrell - 12/04/2023 3:37 PM
5897584895f62ada8887deee054cc79f
d698b27e3fbc1e71af0d3def559b10a6
 
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:
          Powered by