Compliance Inspection Compliance Inspection Compliance Inspection # CI-2017-0721, Submission # Submission-2017-0778, UID # 8878
Status: Compliance Inspection Accepted
 

System Status

System status on date: 05/19/2017 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
21029212100132816 INWOOD AVE N, CITY OF LAKE ELMO2816INWOODAVENLAKE ELMOCITY OF LAKE ELMO55042XIONG TOU101LAKE ELMO HEIGHTS1987
Owner's representative:
Name:
Josh Swedlund
Phone:
(952873 - 3292
Email:
swedlund.midwest@frontiernet.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

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: Yes
Date of installation: 06/01/1987

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging? No
Drainfield has at least a two-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:
Boring:
1-6" 10yr 2/2 loam
7-76" 10yr 4/4 & 4/6 silty clay loam
No redox
A. Bottom of distribution media: 48 Decimal Feet
B. Periodically saturated soil/bedrock: 72 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:
1250 gal septic & gravity drainfield
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Sewer Services, IncL2502952-873-329225648 200th St Belle Plaine, MN 56011YesYesNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: noemail@noemail.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 #2151 (06/08/2017)

Charge Cost Quantity Total
Non-Taxable
added 06/08/2017 3:25 PM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 06/08/2017$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantJosh Swedlund - 06/08/2017 3:28 PM - witnessed by Kati Hallermann
bfd8d57d1c1f7896deaf21f2165d0515
9ed5d7c44451287de03413d35a51fcd1
 
#1 Compliance Inspection AcceptedKati Hallermann - 06/08/2017 3:28 PM
1a9fd03d5a76b55fba34db5ccb833c70
ec543be38028e1e0dc44f0c723058d66
 
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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