Compliance Inspection Compliance Inspection Compliance Inspection # CI-2017-0741, Submission # Submission-2017-0809, UID # 9113
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/05/2017 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
21029211400148815 27TH ST N, CITY OF LAKE ELMO881527THSTNLAKE ELMOCITY OF LAKE ELMO55042PARKER JOHN A & NANCY L42TABLYN PARK 2ND ADD1984
Owner's representative:
Name:
Larry Christiansen
Phone:
(651333 - 0281
Email:
noemail@noemail.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

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):
Observed liquid level below operating depth

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.:
No
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: 36 Decimal Feet
B. Periodically saturated soil/bedrock: 0 Decimal Feet
C. System separation: 36 Decimal Feet
D. Required compliance separation: 36 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:
2-1000gal septic tanks one 1000gal lift station 3 trenches @ 84'each
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Scandia Compliance Inspections, LLCL3911651-433-330316115 Quality Trl N Scandia, MN 55073NoNoNoNoNo
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 #2224 (06/22/2017)

Charge Cost Quantity Total
Non-Taxable
added 06/22/2017 10:43 AM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 06/22/2017$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantLarry Christiansen - 06/22/2017 10:44 AM - witnessed by Kati Hallermann
c1481a9d10451ce77645e5cfd17b74b8
dabc743c6afc550ae41ed222c78b3030
 
#1 Compliance Inspection AcceptedKati Hallermann - 06/22/2017 10:44 AM
57c6c9a031d0cf2805ba8076844c97f5
ae9f06a30825e228dcc0d1696c2d58a7
 
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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