SSTS Permitting

Compliance Inspection Compliance Inspection Compliance Inspection # CI-2023-3763, Submission # Submission-2023-3993, UID # 50032
Status: Compliance Inspection Accepted

System Status

System status on date:

11/15/2023

System Status:

Compliant

Property Information

Property Information:

Compliance Status		Property Record		Property Address								Property Owner	Property Attributes
Compliance Expiration	Compliance Status	Parent GeoCode	PIN	Site Address	Building Number	Street Name	Type	Dir	City	Municipality	zip	Owner	Lot	Block	Plat	Year Built	Property Hold
			1102820420039	16590 UPPER 15TH ST S, CITY OF LAKE ST CROIX BEACH	16590	UPPER 15TH	ST	S	LAKELAND	CITY OF LAKE ST CROIX BEACH	55043	BEARD MADELINE R				1940

Property Owner's Mailing Address
(if different than property address):

3656 Lena Ave, Apt 2

Idaho Falls	ID	83401

Owner's representative:

Name:

Tom Trooien

Phone:

(651

) 439

- 7323

Email:

tomtrooien@aol.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 Homeowner testimony (See Comments/Explanation)

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 Examined construction records Examined empty (pumped) tank(s)
Comments/Explanation:	The tank was at normal operating level, then was pumped through the inspection pipe. Lowered a light & camera into the empty tank - bottom, wall,s cover, baffles & maintenance hole cover ok.

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:	09/28/1978

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)
A. Bottom of distribution media:	2.9 Decimal Feet
B. Periodically saturated soil/bedrock:	6 Decimal Feet
C. System separation:	3.1 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:

File 1: 16590_Upper_15h_St_S_comp_report.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
All State Septic Services	L1568	651-439-7323	12155 Norell Ave N Stillwater, MN 55082	No	No	No	Yes	Yes

Please search for and choose SELF/OTHER if what you need does not appear in the list

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 #9770 (11/15/2023)

Charge	Cost	Quantity	Total
Non-Taxable
2025 Compliance Inspection Fee added 11/15/2023 4:54 PM $47 Flat Fee	$45.00	x 1	$45.00
Subtotal			$45.00 0
Grand Total
Total			$45.00
Payment 11/15/2023			$45.00
Due			$0.00

Action: Print

Approvals

Approval	Signature	Options
Applicant	Tom Trooien - 11/15/2023 4:54 PM f360e562fb1164feab28ca249a8565d5 ce8cf77812d0aa2b2f4ba8864473c472
#1 Compliance Inspection Accepted	Sarah Borrell - 12/22/2023 11:40 AM eb4ef39290c23ca386a04df47fbdb7bd a4597dd1247a2d6afe1ad203e037ba12

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

Text:
File(s):

Create Letter

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

Letter of Compliance

Certificate of Compliance:

Letter of Non-Compliance

Letter of Non-Compliance: