Compliance Inspection Compliance Inspection Compliance Inspection # CI-2017-0726, Submission # Submission-2017-0771, UID # 8824
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/02/2017 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
360272111000111000 MANNING AVE S, CITY OF COTTAGE GROVE11000MANNINGAVESHASTINGSCITY OF COTTAGE GROVE55033PEREZ NORA E ETAL1996
Owner's representative:
Name:
Deb Kleis
Phone:
(651398 - 8768
Email:
debkleis@aol.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
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
No excessive ponding in D-boxes.Ran water for 30 minutes. All effluent flowed to second trench. 

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):
Probed tank(s) bottom
Examined construction records
Examined empty (pumped) tank(s)
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
Effluent levels in tanks normal before pumping. No visible faults in empty tanks.
Baffles in place. Manholes to grade. Top of tanks 36" below grade

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: Yes
Date of installation: 08/30/1996

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):
Two previous verifications (Attach boring logs)
A. Bottom of distribution media: 4 Decimal Feet
B. Periodically saturated soil/bedrock: 7 Decimal Feet
C. System separation: 3 Decimal Feet
D. Required compliance separation: 3 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

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Benson Septic ServiceL190651-325-655518070 218th St E Welch, MN 55089NoYesYesYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: rogerwbenson@embarqmail.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 #2121 (06/02/2017)

Charge Cost Quantity Total
Non-Taxable
added 06/04/2017 7:42 AM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 06/04/2017$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
Applicantroger w. benson - 06/04/2017 7:42 AM
441cd80fe50f7375299fa654f781204f
b112220186a984165a849f27ec8cc548
 
#1 Compliance Inspection AcceptedKati Hallermann - 06/09/2017 11:49 AM
fb6418edb76166804a6d18c86b3fe10c
1a5cbb064e20330780274af51a9a33c6
 
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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