SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2017-0691, Submission # Submission-2017-0723, UID # 8489
Status: System Replaced
Status: System Replaced
System Status
| System status on date: | 05/27/2017 | System Status: | Noncompliant |
System - Noncompliant
| Reason(s) for noncompliance: | Soil Separation (Compliance Component #4) - Failing to protect groundwater |
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: | 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: |
No |
| Other issues (electrical hazards, etc.) to immediately and adversely impact public health or safety: |
No |
| Explain: | See Report |
| System is non protective of groundwater for other conditions as determined by the inspector: |
No |
| Explain: | See Report |
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.: |
No |
| Drainfield meets the designed vertical separation distance from periodically saturated soil or bedrock.: |
No |
| Verification method(s): | Conducted soil observation(s) (Attach boring logs) 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
| Comments or recommendations: | See Report markkuschke@yahoo.com |
| Attach Files: |
|
9260_84th_St_N.pdfCertification
| Inspector: |
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 #2025 (05/01/2017)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 05/01/2017 6:31 PM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
| Grand Total | |||
| Total | $40.00 | ||
| Payment 05/16/2017 | $40.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Brian Humpal - 05/01/2017 6:31 PM bfaa4b1a5de9d1bf35be261a994e0c70 c5b5161200b6bf30e5f955b3613908bf | |
| #1 Compliance Inspection Accepted | Christopher W. LeClair REHS - 05/19/2017 8:47 AM 9a6f0577f3c407726bceb8832bd3ca1b f3010abd423280a28b82081813192eb5 |
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: |
|