Compliance Inspection Compliance Inspection Compliance Inspection # CI-2017-0723, Submission # Submission-2017-0775, UID # 8870
Status: System Replaced
 

System Status

System status on date: 06/06/2017 System Status: Noncompliant

System - Noncompliant

Reason(s) for noncompliance:
Tank Integrity (Compliance Component #2) - Failing to protect groundwater

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
16029212100228312 38TH ST N, CITY OF LAKE ELMO831238THSTNLAKE ELMOCITY OF LAKE ELMO55042RASMUSSEN CARISA & ANDREW41BORDNER'S GARNER FARMETTES1971No
Owner's representative:
Name:
Bill Gulden
Phone:
(651387 - 2640
Email:
bentstone@comcast.net

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)
Comments/Explanation:
See attached.

Tank Integrity

System consists of seepage pit,
cesspool, drywell, or leaching pit:
Yes
Sewage tank(s) leak below their
designed operating depth:
Yes
: Septic Tank
Verification method(s):
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
See attached.

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: 96.8 Decimal Feet
B. Periodically saturated soil/bedrock: 92.5 Decimal Feet
C. System separation: 4.3 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

Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Zierke Soil Testing, LLCL119651-249-134628587 Jeffrey Ave Chisago City, MN 55013NoNoNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: benzierke@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 #2148 (06/07/2017)

Charge Cost Quantity Total
Non-Taxable
added 06/07/2017 2:34 PM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 06/07/2017$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantBenjamin J. Zierke - 06/07/2017 2:34 PM
571f95ba1695d63a30800a764a584dfc
7d92feb7ff6349102c27c905614d5adb
 
#1 Compliance Inspection AcceptedChristopher W. LeClair REHS - 06/09/2017 9:29 AM
38d937f2c67ce4884687c067160750bc
c13e2a24ad4d8c5269732b72a6f69a92
 
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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