Compliance Inspection Compliance Inspection Compliance Inspection # CI-2020-2161, Submission # Submission-2020-2257, UID # 27486
Status: System Replaced
 

System Status

System status on date: 04/22/2020 System Status: Noncompliant

System - Noncompliant

Reason(s) for noncompliance:
Soil Separation (Compliance Component #4) - Failing to protect groundwater

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
04031212200056500 177TH ST N, CITY OF HUGO6500177THSTNHUGOCITY OF HUGO55038KATTARIA MOHAMMED A32HARDWOOD CREEK ESTATES1976
Owner's representative:
Name:
Anita Handlos
Phone:
(123456 - 7890
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
Excessive ponding in soil system/D-boxes

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
Comments/Explanation:
Lowered underwater camera into tank - baffles 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
System is non protective of groundwater for other
conditions as determined by the inspector:
No

Date of Install

Date of install known: No

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.:
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:
Inspector indicates system installed in 1976

Soil observation:
0-4''- 10YR 4/2 Fine Sand
4-16'-' 10YR 4/3 Fine Sand
16-20''- 10YR 5/3 Loamy Fine Sand With 7.5YR 5/8 & 10YR 6/2 Redox
20-34''- 10YR 3/4 Medium To Loamy Sand With 7.5YR 5/8 & 10YR 6/2 Redox
34-42''- 10YR 5/2 Very Fine Sand (Depleted Matrix)(Moist) With 7.5YR 5/8 Redox
A. Bottom of distribution media: 4 Decimal Feet
B. Periodically saturated soil/bedrock: 1.3 Decimal Feet
C. System separation: 0 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
Midwest Sewer ServicesL2896651-492-75506616 Indian Wells Trail Grant, MN 55110YesYesYesYesYes
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 #5432 (04/30/2020)

Charge Cost Quantity Total
Non-Taxable
added 04/30/2020 4:22 PM

$41 Flat Fee

$41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 05/12/2020$41.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantBrian Humpal - 04/30/2020 4:22 PM
cdb02d93f9d41980c35cf178d41c4cd4
be0ba5e5f493e319d69454a143008681
 
#1 Compliance Inspection AcceptedPaul O'Neel - 05/14/2020 10:47 AM
e6694fa91f4e1ac2558e7d349de8a618
c1c7cbac2cfb14208033c68462607bd1
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    File(s):
      Compliance Letter Type: Failed System, Notice and Order to Comply, Separation Who's signature should be on the letter? Paul O'Neel Permit number to reference in "No Replace" letter:
      Was the letter sent? Yes Compliant/Non-Compliant:
      Certificate of Compliance:
        Letter of Non-Compliance:
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