Compliance Inspection Compliance Inspection Compliance Inspection # CI-2020-2157, Submission # Submission-2020-2276, UID # 27784
Status: Compliance Inspection Accepted
 

System Status

System status on date: 05/13/2020 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
28030212200018015 80TH ST N, CITY OF GRANT801580THSTNSTILLWATERCITY OF GRANT55082BARTNESS HEATH & DAINNA2012
Owner's representative:
Name:
Joel
Phone:
(651472 - 4772
Email:
joel@hauerconstruction.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
Comments/Explanation:
see repot

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: 03/01/2013

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.:
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)
Two previous verifications (Attach boring logs)
Comments/Explanation:
see attached report
A. Bottom of distribution media: 96.78 Decimal Feet
B. Periodically saturated soil/bedrock: 93.7 Decimal Feet
C. System separation: 3.03 Decimal Feet
D. Required compliance separation: 2.55 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

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Ten Thirty Environmental Solutions, SBCL4082612-248-42811684 132nd Ave NE Blaine, MN 55449NoNoYesYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: alex.pepin@tenthirtyenvironmental.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 #5513 (05/13/2020)

Charge Cost Quantity Total
Non-Taxable
added 05/13/2020 5:23 PM

$41 Flat Fee

$41.00 x 1 $41.00
Grand Total
Total $41.00
Payment 05/13/2020$41.00
Due$0.00

Approvals

ApprovalSignature
ApplicantAlex Pepin - 05/13/2020 5:23 PM
f11e16c6704d65a618d9767bdb08342c
5d0e10d3f29a776ecf6060aed4f6a192
#1 Compliance Inspection AcceptedDenise Lange - 05/14/2020 8:19 AM
7bf92d63362808c59fbd5610f1910f43
b55ed275665d1acc416abd5d9ae9a47c
Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

    Internal Notes

    Text:
    File(s):
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