Compliance Inspection Compliance Inspection Compliance Inspection # CI-2024-3947, Submission # Submission-2024-4184, UID # 53311
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/06/2024 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
27029203300061080 PARIS AVENUE CT N, TOWN OF WEST LAKELAND1080PARIS AVENUECTNSTILLWATERTOWN OF WEST LAKELAND55082MOY RALPH H & SHELLY A102ST CROIX VISTA1998
Owner's representative:
Name:
Shelly Moy
Phone:
(651270 - 5725
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
Homeowner testimony (See Comments/Explanation)
Comments/Explanation:
Homeowner stated they have not had any problems with the 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):
Examined empty (pumped) tank(s)
Comments/Explanation:
Manholes dug up for inspection.  Tanks water tight at time of inspection.  Suggested that they added risers.

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: 09/28/1998

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: 3 Decimal Feet
B. Periodically saturated soil/bedrock: 6 Decimal Feet
C. System separation: 3 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
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 #10305 (06/11/2024)

Charge Cost Quantity Total
Non-Taxable
added 06/11/2024 7:16 PM

$47 Flat Fee

$46.00 x 1 $46.00
Grand Total
Total $46.00
Payment 06/11/2024$46.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantShelley L. Schlomka - 06/11/2024 7:16 PM
4965df020be0214944e04992f8334a64
429ffd56a62f780f0b3727907d61cb96
 
#1 Compliance Inspection AcceptedSarah Borrell - 07/19/2024 11:54 AM
bf453aa25b12c9763165a3cc0d5e08a3
d51e20b20d82896930b6fb3898df05ff
 
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