Compliance Inspection Compliance Inspection Compliance Inspection # CI-2024-4022, Submission # Submission-2024-4266, UID # 54364
Status: Compliance Inspection Accepted
 

System Status

System status on date: 08/01/2024 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
23030211300148591 KIMBRO AVE N, CITY OF GRANT8591KIMBROAVENSTILLWATERCITY OF GRANT55082SAVIGNAC EDWARD & KATHLEEN M12GLEN OAK TERRACE1967
Owner's representative:
Name:
Ed Savignac
Phone:
(612772 - 8701
Email:
8591@hotmail.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):
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
Visual Inspection of the area. No signs of sewage to the ground surface. The homeowners did not report back-ups in to the
house.

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: 10/25/2006

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.:
No
Verification method(s):
Conducted soil observation(s) (Attach boring logs)
A. Bottom of distribution media: 2.5 Decimal Feet
B. Periodically saturated soil/bedrock: 6 Decimal Feet
C. System separation: 3.5 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:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Kloeppner Services & Designs LLCL4043763-843-41143540 Lexington Ave N Ste 203 Shoreview, MN 55126NoNoYesYesYes
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 #10502 (08/04/2024)

Charge Cost Quantity Total
Non-Taxable
added 08/04/2024 9:17 AM

$47 Flat Fee

$46.00 x 1 $46.00
Grand Total
Total $46.00
Payment 08/04/2024$46.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantJesse J. Kloeppner - 08/04/2024 9:17 AM
8c381d0e7ad83538b6955d6ff8ed8fb1
b9d8d87ea8c3d68ba4288e3ad66f9328
 
#1 Compliance Inspection AcceptedSarah Borrell - 10/08/2024 4:08 PM
55d15eee01a80f883b6bfe2edcb50bc3
ed1a352dfa8a154ed1dc35412a5e61e6
 
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:
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