Compliance Inspection Compliance Inspection Compliance Inspection # CI-2019-1889, Submission # Submission-2019-1972, UID # 23631
Status: Compliance Inspection Accepted
 

System Status

System status on date: 08/29/2019 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
01027212200026005 LAMAR AVE S, CITY OF COTTAGE GROVE6005LAMARAVESCOTTAGE GROVECITY OF COTTAGE GROVE55016NASH KATHRYN M & ANDREW P1920
Property Owner's Mailing Address
(if different than property address):
6005 Lamar Ave S
Cottage Grove MN 55016
Owner's representative:
Name:
Shirley Erickson
Phone:
(651343 - 9117
Email:
sssepticsolutions@gmail.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):
Examined Tank Integrity Form (Attach)
Comments/Explanation:
Please see tank integrity form.

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: 06/01/2004

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:
Bottom of media 9"
Stopped borings at 50"
System Seperation 40"
A. Bottom of distribution media: 1 Decimal Feet
B. Periodically saturated soil/bedrock: 4 Decimal Feet
C. System separation: 3 Decimal Feet
D. Required compliance separation: 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

Comments or recommendations:
New system installed and brought to code in 2004.  Sale of home requires compliance inspection.  40" good soil under soil treatment area.
Attach Files:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
D. Schlomka Inc.L1106320-384-791141788 Fleming Logging Rd Hinckley, MN 55037NoYesNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: sssepticsolutions@gmail.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 #4797 (08/31/2019)

Charge Cost Quantity Total
Non-Taxable
added 08/31/2019 12:19 PM

$41 Flat Fee

$41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 08/31/2019$41.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantShelley L. Schlomka - 08/31/2019 12:19 PM
f36a854bf2e22410955e5d1642dc4cab
1fae4a80a6079ca41fd2311eea761c7e
 
#1 Compliance Inspection AcceptedKati Hallermann - 09/12/2019 7:47 AM
d174bbad282ed784d00f5c993c663c17
0d2171b7a14b8731ca05f7d67ddab08a
 
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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