Compliance Inspection Compliance Inspection Compliance Inspection # CI-2017-0590, Submission # Submission-2017-0619, UID # 7718
Status: System Replaced
 

System Status

System status on date: 02/27/2017 System Status: Noncompliant

System - Noncompliant

Reason(s) for noncompliance:
Impact on Public Health (Compliance Component #1) - Imminent threat to public health and safety
Soil Separation (Compliance Component #4) - Failing to protect groundwater

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
230302143000610663 83RD STREET CT N, CITY OF GRANT1066383RD STREETCTNSTILLWATERCITY OF GRANT55082CHIARELLA LINDA M52FOX RUN1974
Owner's representative:
Name:
Owner
Email:
noemail@noeamil.com

Impact on Public Health

System discharges sewage to
the ground surface:
Yes 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:
see report

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):
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
see report

Other Compliance Conditions

Maintenance hole covers are damaged, cracked,
unsecured, or appear to be structurally unsound:
Unknown
Other issues (electrical hazards, etc.) to
immediately and adversely impact public
health or safety:
Unknown
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? Yes
Drainfield has at least a three-foot vertical separation
distance from periodically saturated soil or bedrock.:
No
Drainfield meets the designed vertical separation
distance from periodically saturated soil or bedrock.:
No
Verification method(s):
Other (See Comments/Explanation)
Comments/Explanation:
see report
A. Bottom of distribution media: 0 Decimal Feet
B. Periodically saturated soil/bedrock: 0 Decimal Feet
C. System separation: 0 Decimal Feet
D. Required compliance separation: 0 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
Midwest Sewer ServicesL2896651-492-75506616 Indian Wells Trail Grant, MN 55110YesYesYesYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: brian@midwestsoiltesting.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 #1825 (02/27/2017)

Charge Cost Quantity Total
Non-Taxable
added 02/27/2017 1:32 PM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 03/10/2017$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantBrian Humpal - 02/27/2017 1:32 PM
b3321156e7c2591facdd7cab656d3e82
f778b4a0a17638fde918a2f7a03e2e03
 
#1 Compliance Inspection AcceptedChristopher W. LeClair REHS - 03/13/2017 9:59 AM
3eea483d5ef81078080e01e02d21a3b3
0e34520cdd9842adcf95aea8afa49567
 
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:
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