SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2024-3966, Submission # Submission-2024-4198, UID # 53453
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 06/14/2024 | System Status: | Compliant |
Property Information
| Property Information: | |||||||||||||||||
| Owner's representative: |
|
||||||||||||||||
[
]
[ 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): | Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | Visual Inspection of the area. |
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 pumped and visually inspected with camera. No signs of cracks or leaking in any of the tanks. |
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 |
| Explain: | Inspected area around tanks. No signs of damage. |
Date of Install
| Date of install known: | Yes |
| Date of installation: | 06/19/1974 |
Soil Separation
| Shoreland/Wellhead Protection/Food, beverage, lodging? | Yes |
| 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: | No Periodically saturated soil/bedrock observed. Trench depth verified. This form does not allow for 5b to be answered. 5b. Drainfield has a three-foot vertical separation distance from periodically saturated soil/bedrock. = YES |
| A. Bottom of distribution media: | 20 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 5.2 Decimal Feet |
| C. System separation: | 3.2 Decimal Feet |
| D. Required compliance separation: | 2.6 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
| Comments or recommendations: | See attached soil boring log and site plan for location of trenches and boring. |
| Attach Files: |
KSD_SSTS_INSPECTION_10271_209th_St_N_Forest_Lake_Ver_1.0_6-17-24.pdfCertification
| Inspector: |
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): | Jesse Kloeppner |
| Inspector Email Address: | jesse@ksd-mn.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 #10336 (06/19/2024)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 06/19/2024 11:33 AM $47 Flat Fee |
$46.00 | x 1 | $46.00 |
| Grand Total | |||
| Total | $46.00 | ||
| Payment 06/19/2024 | $46.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Jesse J. Kloeppner - 06/19/2024 11:33 AM 59f4d87246bfc6a54364f3a2ff1a751b ed30be8146cb6e996e0dfbc32d049761 | |
| #1 Compliance Inspection Accepted | Sarah Borrell - 09/04/2024 12:59 PM cb77443f6fa6c0a8b93355cd07908f2d b40bc58a9714568319473755141dc74d |
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: |