Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0378, Submission # Submission-2016-0409, UID # 4952
Status: Compliance Inspection Accepted
 

System Status

System status on date: 08/29/2016 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
330272011000514777 110TH ST S, TOWN OF DENMARK14777110THSTSHASTINGSTOWN OF DENMARK55033THIEL GREG & MARCIA121CHERRYWOOD RIDGE1986
Owner's representative:
Name:
Clark Tufte
Phone:
(612710 - 4401
Email:
ctufte@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
Searched for seeping in yard/backup into home
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
level in drop boxes normal
no black soil above dispersal system

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):
Probed tank(s) bottom
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
effluent level in tanks normal

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: 05/22/1988

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging? No
Drainfield has at least a two-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)
Comments/Explanation:
0-19" 10yr2/1 silt loam
19-38 10yr4/3 silt loam
38-50 10yr4/3 sandy loam
50-54" 10yr5/4 sandy loam
A. Bottom of distribution media: 2.5 Decimal Feet
B. Periodically saturated soil/bedrock: 4.5 Decimal Feet
C. System separation: 2 Decimal Feet
D. Required compliance separation: 2 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
Benson Septic ServiceL190651-325-655518070 218th St E Welch, MN 55089NoYesYesYesYes
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): roger benson
Inspector Email Address: rogerwbenson@embarqmail.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 #1361 (09/10/2016)

Charge Cost Quantity Total
Non-Taxable
added 09/10/2016 9:39 AM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 09/10/2016$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
Applicantroger w. benson - 09/10/2016 9:40 AM
cf846bb217e8c60b6fdc41799d2eb48a
c3b0802d3e8b6db889458435e786496b
 
#1 Compliance Inspection AcceptedKati Hallermann - 09/14/2016 8:20 AM
c7bbd784af8178217c96a8c9ddf328b7
02d38b684531e95b136d7c5700177ec4
 
Inspection has been approved. All signatures have been obtained.
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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