SSTS Permitting Sandbox site
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2020-2443, Submission # Submission-2020-2611, UID # 31954
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 12/07/2020 | System Status: | Compliant |
Property Information
| Property Information: | |||||||||||||||||
| Property Owner's Mailing Address (if different than property address): |
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| Owner's representative: |
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[ Search Result Limit: 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: | 06/01/2004 |
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) |
| A. Bottom of distribution media: | 2 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 6 Decimal Feet |
| C. System separation: | 4 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
| Attach Files: |
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Scan0028.pdfCertification
| Inspector: |
Please search for and choose SELF/OTHER if what you need does not appear in the list
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| 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 #6335 (12/20/2020)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 12/20/2020 4:20 PM $41 Flat Fee |
$41.00 | x 1 | $41.00 |
| Grand Total | |||
| Total | $41.00 | ||
| Payment 12/20/2020 | $41.00 | ||
| Due | $0.00 | ||
Approvals
| Approval | Signature |
|---|---|
| Applicant | Shelley L. Schlomka - 12/20/2020 4:21 PM 4ac63d03f6b8371eeb00d4bc6f39757d 57c10b9e72aa257ecc1332f7b1986472 |
| #1 Compliance Inspection Accepted | Denise Lange - 12/21/2020 11:09 AM 4e9d61eb0921fbc46432538bafb5e664 d1e61712993ac6e7ed2cc27d6dda7cd5 |
Inspection has been approved. All signatures have been obtained.
Public Notes
| Text: | |
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Internal Notes
| Text: | |
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