Compliance Inspection Compliance Inspection Submission # Submission-2024-4420, UID # 57239
Status: Pending Review
 

System Status

System status on date: 12/23/2024 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
11027214100057710 LAMAR AVE S, CITY OF COTTAGE GROVE7710LAMARAVESCOTTAGE GROVECITY OF COTTAGE GROVE55016MARTY JOSEPH E1946
Owner's representative:
Name:
Sculpin Holdings
Phone:
(612293 - 9385
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
Comments/Explanation:
HOUSE VACANT AT TIME OF INSPECTION

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 water tight at time of inspection.  Manholes dug open, roots removed from baffles, risers added.  House was vacant at time of inspection,  I informed the representative the risks of pumping the tanks during the colder months.

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: No

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):
Conducted soil observation(s) (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: 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 #10898 (12/24/2024)

Charge Cost Quantity Total
Non-Taxable
added 12/24/2024 1:23 PM

$47 Flat Fee

$46.00 x 1 $46.00
Grand Total
Total $46.00
Payment 12/24/2024$46.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantShelley L. Schlomka - 12/24/2024 1:23 PM
76d1d6f11c9a28524260b52ff14fc12c
8d5a2ee7e8515dbb6f71aa7150f012fe
 
#1 Compliance Inspection Accepted 
You do not have the necessary rights for this signature
Inspection will be approved after the above signatures are obtained.
Text:
File(s):
    Text:
    File(s):
      Compliance Letter Type: Who's signature should be on the letter? Permit number to reference in "No Replace" letter:
      Was the letter sent? Compliant/Non-Compliant:
      Certificate of Compliance:
        Letter of Non-Compliance:
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