Compliance Inspection Compliance Inspection Compliance Inspection # CI-2017-0835, Submission # Submission-2017-0894, UID # 9814
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/23/2017 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
020302114000311589 LANSING AVE N, CITY OF GRANT11589LANSINGAVENSTILLWATERCITY OF GRANT55082ENGLUND DAVID C1973
Owner's representative:
Name:
Clark Nyberg
Phone:
(651214 - 1470
Email:
gktauer@cbburnet.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
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 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.:
No
Verification method(s):
Conducted soil observation(s) (Attach boring logs)
Comments/Explanation:
see report
A. Bottom of distribution media: 48 Decimal Feet
B. Periodically saturated soil/bedrock: 0 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:
1200 gallon septic tank (estimated) & gravity, rock trench drainfield
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
All State Septic ServicesL1568651-439-732312155 Norell Ave N Stillwater, MN 55082NoNoNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: tomtrooien@aol.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 #2416 (08/02/2017)

Charge Cost Quantity Total
Non-Taxable
added 08/02/2017 10:53 AM

$40 Flat Fee

$40.00 x 1 $40.00
Grand Total
Total $40.00
Payment 08/02/2017$40.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantTom Trooien - 08/02/2017 10:54 AM - witnessed by Kati Hallermann
be81822ce83bbeed7e7592d5717a3855
33a4fa9094bfe3c4d9b6ae9fb0f72818
 
#1 Compliance Inspection AcceptedKati Hallermann - 08/02/2017 10:54 AM
3ad536e0b85dfab083f552d699d5ab42
2fe85c7eb3fee1e226a84619bc26820b
 
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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