SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2023-3712, Submission # Submission-2023-3935, UID # 49195
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 09/26/2023 | System Status: | Compliant |
Property Information
| Property Information: | |||||||||||||||||
| Owner's representative: |
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[ Search Result Limit: 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 empty (pumped) tank(s) |
| 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: | 09/05/2005 |
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): | Two previous verifications (Attach boring logs) |
| A. Bottom of distribution media: | 96.5 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 93 Decimal Feet |
| C. System separation: | 3.5 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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Belz_Inspection_9-26-23.pdfCertification
| 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: | 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 #9630 (10/06/2023)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 10/06/2023 11:17 PM $47 Flat Fee |
$45.00 | x 1 | $45.00 |
| Grand Total | |||
| Total | $45.00 | ||
| Payment 10/06/2023 | $45.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Benjamin J. Zierke - 10/06/2023 11:17 PM 0943f37991273a9be23ed42f0d374967 5bc284a838d89aabfe40fe7d813f7744 | |
| #1 Compliance Inspection Accepted | Sarah Borrell - 12/05/2023 8:20 AM 6fad665f8529cc1f949935516dde0192 911b2383ae93c890339cb2eb56aad5d4 |
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: |