SSTS Permitting Sandbox site

System Status

System status on date:

02/06/2020

System Status:

Noncompliant

System - Noncompliant

Reason(s) for noncompliance:

Soil Separation (Compliance Component #4) - Failing to protect groundwater

Property Information

Property Information:

Compliance Status		Property Record		Property Address								Property Owner	Property Attributes
Compliance Expiration	Compliance Status	Parent GeoCode	PIN	Site Address	Building Number	Street Name	Type	Dir	City	Municipality	zip	Owner	Lot	Block	Plat	Year Built	Property Hold
			0302921420008	9580 53RD ST N, CITY OF LAKE ELMO	9580	53RD	ST	N	LAKE ELMO	CITY OF LAKE ELMO	55042	CHAPMAN JASON M & ERIN B	9	1	ARABIAN HILLS	1993

Owner's representative:

Name:

Steve Moeller

Phone:

(123

) 456

- 7890

Email:

noemail@email.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 Excessive ponding in soil system/D-boxes Other methods not listed (See Comments/Explanation)	Comments/Explanation:	Although not a compliance criteria, it should be noted that gravelless pipe is no longer approved for installation in the State of Minnesota and we have had experience with this product having significantly reduced performance and/or life expectancy. We cannot guarantee the performance of this system beyond the compliance date (2/6/2020).

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 methods not listed (See Comments/Explanation)
Comments/Explanation:	Lowered underwater camera into tanks - baffels and tank walls OK.

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
Explain:	See Report
System is non protective of groundwater for other conditions as determined by the inspector:	No
Explain:	See Report

Date of Install

Date of install known:	Yes
Date of installation:	01/01/2003

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging?	Yes
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.:	No
Verification method(s):	Conducted soil observation(s) (Attach boring logs) Other (See Comments/Explanation)
Comments/Explanation:	See Report
A. Bottom of distribution media:	1.5 Decimal Feet
B. Periodically saturated soil/bedrock:	3 Decimal Feet
C. System separation:	1.5 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:	See Report
Attach Files:	File 1: 9580_53rd_Street_N.pdf

Certification

Inspector:

Name	License Number	Phone Number	Address	Maintainer	Installer	Service Provider	Designer	Inspector
Midwest Sewer Services	L2896	651-492-7550	6616 Indian Wells Trail Grant, MN 55110	Yes	Yes	Yes	Yes	Yes

Please search for and choose SELF/OTHER if what you need does not appear in the list

Inspector Email Address:

brian@midwestsoiltesting.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 #5228 (02/10/2020)

Charge	Cost	Quantity	Total
Non-Taxable
Compliance Inspection Fee added 02/10/2020 2:50 PM $41 Flat Fee	$41.00	x 1	$41.00
Subtotal			$41.00 0
Grand Total
Total			$41.00
Payment 02/10/2020			$41.00
Due			$0.00

Approvals

Approval	Signature
Applicant	Brian Humpal - 02/10/2020 2:50 PM 3e0d3c3de18af33436c4dc69c2e83c52 2d56b2174450a0181a0b7fdaaa5cd779
#1 Compliance Inspection Accepted	Tyler Dale - 02/21/2020 3:24 PM 37bb6a452ea75b71227d774e6d8f59a8 484a918f182a6fac49092d0987e40406

Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

Internal Notes

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