SSTS Permitting
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0013, Submission # Submission-2016-0020, UID # 909
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
System status on date: | 12/08/2015 | System Status: | Compliant |
Property Information
Property Information: | |||||||||||||||||
Property Owner's Mailing Address (if different than property address): |
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Owner's representative: |
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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 Excessive ponding in soil system/D-boxes Homeowner testimony (See Comments/Explanation) |
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 Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | Lowered underwater camera into tanks, baffles and tank walls OK. |
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: | 2.5 Decimal Feet |
B. Periodically saturated soil/bedrock: | 5 Decimal Feet |
C. System separation: | 4.3 Decimal Feet |
D. Required compliance separation: | 4.3 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: |
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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 #443 (01/04/2016)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 01/04/2016 3:18 PM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
Grand Total | |||
Total | $40.00 | ||
Due | $40.00 |
Action: Print
Approvals
Approval | Signature | Options |
---|---|---|
Applicant | Brian Humpal - 01/04/2016 3:19 PM - witnessed by Stephanie Holt 48aa444aff92053b0e80f26639ef8e17 a706bc52d231ca24b5586600ef894113 | |
#1 Compliance Inspection Accepted | Stephanie Holt - 01/04/2016 3:19 PM bbedfeda9a4149a1a6b3b01950577725 21cdf5a73ffb7427a3ef5dfd4c582d5d |
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: |