Compliance Inspection Compliance Inspection Compliance Inspection # CI-2019-2026, Submission # Submission-2019-2121, UID # 25472
Status: Compliance Inspection Accepted
 

System Status

System status on date: 12/04/2019 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
350292033004616234 2ND ST N, CITY OF LAKELAND162342NDSTNLAKELANDCITY OF LAKELAND55043NAGEL DEVIN & JENNA BROLIN42PINE MEADOWS 2ND ADD1976No
Owner's representative:
Name:
Tom Trooien
Phone:
(651439 - 7323
Email:
tomtrooien@aol.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):
Probed tank(s) bottom
Examined construction records

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: 11/12/1992

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging? No
Drainfield has at least a two-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: 4 Decimal Feet
B. Periodically saturated soil/bedrock: 6 Decimal Feet
C. System separation: 2 Decimal Feet
D. Required compliance separation: 2 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:
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 #5102 (12/05/2019)

Charge Cost Quantity Total
Non-Taxable
added 12/05/2019 9:46 AM

$41 Flat Fee

$41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 12/05/2019$41.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantTom Trooien - 12/05/2019 9:46 AM
7a61d8972eae38b1429b3b084eded7f6
48a6289bfd49ae9e2487afe4c6d5c62a
 
#1 Compliance Inspection AcceptedDenise Lange - 12/05/2019 2:06 PM
4ce2be7e97aad987eb56d07309fe8f7f
fdb46e98970e8cc36f8fa33f2c5f2844
 
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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