Compliance Inspection Compliance Inspection Compliance Inspection # CI-2020-2086, Submission # Submission-2020-2182, UID # 27101
Status: Compliance Inspection Accepted
 

System Status

System status on date: 03/03/2020 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
320272024000311373 NEAL AVE S, TOWN OF DENMARK11373NEALAVESHASTINGSTOWN OF DENMARK55033MCCALLUM ROBERT J & VICTORIA M1999
Property Owner's Mailing Address
(if different than property address):
11373 Neal Ave S
Hastings MN 55033
Owner's representative:
Name:
Wendy Gagne
Phone:
(651491 - 6080
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)

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: 08/19/1999

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)
Other (See Comments/Explanation)
Comments/Explanation:
Conducted soil samples and observed original borings
A. Bottom of distribution media: 2 Decimal Feet
B. Periodically saturated soil/bedrock: 7 Decimal Feet
C. System separation: 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

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 #5301 (03/04/2020)

Charge Cost Quantity Total
Non-Taxable
added 03/04/2020 12:45 PM

$41 Flat Fee

$41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 03/04/2020$41.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantShelley L. Schlomka - 03/04/2020 12:45 PM
fe0ba47f57cbcfe36206c536f41c6004
3314e08ac25ef5c2c2173a5e6d439bde
 
#1 Compliance Inspection AcceptedDenise Lange - 03/04/2020 3:19 PM
0f163498f254768bd7ed76a76ffc2481
86dda257f6bfa1b63c0ea33b9464be3f
 
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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