SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2017-0543, Submission # Submission-2017-0575, UID # 7124
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 12/23/2016 | 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): | Searched for surface outlet Searched for seeping in yard/backup into home Homeowner testimony (See Comments/Explanation) |
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) |
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.: |
No |
| Verification method(s): | Conducted soil observation(s) (Attach boring logs) |
| Comments/Explanation: | See Report |
| A. Bottom of distribution media: | 24 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 0 Decimal Feet |
| C. System separation: | 24 Decimal Feet |
| D. Required compliance separation: | 24 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: | 1,250 gallon septic tank & gravity drainfield |
| Attach Files: |
|
16333-01042017110049.pdfCertification
| Inspector: |
Please search for and choose SELF/OTHER if what you need does not appear in the list
|
| Inspector Email Address: | tomtrooein@aol.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 #1749 (01/04/2017)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 01/04/2017 10:35 AM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
| Grand Total | |||
| Total | $40.00 | ||
| Payment 01/04/2017 | $40.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Tom Trooien - 01/04/2017 10:36 AM - witnessed by Kati Hallermann af46784e61bbe61ba19ea69447488b98 c5e1a6e1d40b22adb77559f29c9626de | |
| #1 Compliance Inspection Accepted | Kati Hallermann - 01/04/2017 10:36 AM c038be7b9787f923b5ae59b6ffb2183f df5f1103f771a22e6e4405d2bf724592 |
Inspection has been approved. All signatures have been 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: |