Compliance Inspection Compliance Inspection Compliance Inspection # CI-2024-3873, Submission # Submission-2024-4158, UID # 52966
Status: Compliance Inspection Accepted
 

System Status

System status on date: 05/22/2024 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
350292031001416288 3RD ST N, CITY OF LAKELAND162883RDSTNLAKELANDCITY OF LAKELAND55043MATTSON JOHN N152CROIXLAND ADD1972
Owner's representative:
Name:
Suzanne Devlin
Phone:
(651210 - 1799
Email:
sssepticsolutions@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

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:
Tanks were water tight at time of inspection.   House was vacant.

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: 05/27/1988

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)
A. Bottom of distribution media: 2.5 Decimal Feet
B. Periodically saturated soil/bedrock: 5 Decimal Feet
C. System separation: 2.5 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
SS Septic Solutions LLCL4137651-343-911714845 113th St S Hastings, MN 55033NoYesNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: sssepticsolutions@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 #10244 (05/24/2024)

Charge Cost Quantity Total
Non-Taxable
added 05/24/2024 11:16 AM

$47 Flat Fee

$46.00 x 1 $46.00
Grand Total
Total $46.00
Payment 05/24/2024$46.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantShelley L. Schlomka - 05/24/2024 11:16 AM
08fce81ac6460d76ce579e4f65fd08f1
614d92ead0b5a76f77ba5ed718429f26
 
#1 Compliance Inspection AcceptedSarah Borrell - 05/29/2024 4:14 PM
324d3a3ebfcbc894b9d73a1416c39757
6589c02204690c5590fbb6348df8a1a1
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    Inspector asked me to swap reports out. The first report was incomplete and did not appear different other than missing site plan and soils. (SB)
    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:
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