Compliance Inspection Compliance Inspection Compliance Inspection # CI-2019-1558, Submission # Submission-2019-1615, UID # 19923
Status: Compliance Inspection Accepted
 

System Status

System status on date: 07/30/2018 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
05029204400065225 NORTHBROOK BLVD N, TOWN OF BAYTOWN5225NORTHBROOKBLVDNSTILLWATERTOWN OF BAYTOWN55082SHAUGHNESSY ANDREA L & RYAN P1961
Owner's representative:
Name:
Shelly Michaelis
Phone:
(651485 - 4444
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
Homeowner testimony (See Comments/Explanation)
Comments/Explanation:
There have been no issues

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
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: 11/16/1999

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)
Comments/Explanation:
see report
A. Bottom of distribution media: 20 Decimal Feet
B. Periodically saturated soil/bedrock: 68 Decimal Feet
C. System separation: 48 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:
Qty (2) septic tanks to gravity drainfield.
System was installed with a permit from Washington County in 1999.
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
David R. BrownL3649651-788-3296PO Box 251026 Woodbury, MN 55125NoNoNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: drufusb1@yahoo.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 #4048 (01/18/2019)

Charge Cost Quantity Total
Non-Taxable
added 01/18/2019 2:33 PM

$41 Flat Fee

$41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 01/22/2019$41.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantDavid Brown - 01/22/2019 9:19 AM - witnessed by Kati Hallermann
ddb3936cfb0de337295c6ce369a428b3
09d180e7fddebea432c5d1dbca57bc0c
 
#1 Compliance Inspection AcceptedKati Hallermann - 01/22/2019 9:20 AM
f8a103e7cba17022ecd2f11650ac9c21
975d6091d219694f349acc009c85e336
 
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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