SSTS Permitting Sandbox site
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2460, Submission # Submission-2021-2646, UID # 32674
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
System status on date: | 02/01/2021 | System Status: | Compliant |
Property Information
Property Information: | |||||||||||||||||
Owner's representative: |
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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): | Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | See Report |
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 empty (pumped) tank(s) |
Comments/Explanation: | Pinkys 2/2/2021 |
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: | 01/01/2011 |
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) Other (See Comments/Explanation) |
Comments/Explanation: | See Report |
A. Bottom of distribution media: | 2.1 Decimal Feet |
B. Periodically saturated soil/bedrock: | 0.83 Decimal Feet |
C. System separation: | 3.2 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: |
Certification
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: | 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 #6407 (02/05/2021)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 02/05/2021 12:36 PM $42 Flat Fee |
$42.00 | x 1 | $42.00 |
Grand Total | |||
Total | $42.00 | ||
Payment 02/08/2021 | $42.00 | ||
Due | $0.00 |
Approvals
Approval | Signature |
---|---|
Applicant | Brian Humpal - 02/05/2021 12:36 PM 07da191d95dddb39f135c6b9166db52a 678daa880241540c48d0e745f145d22a |
#1 Compliance Inspection Accepted | Tyler Dale - 03/03/2021 8:50 AM dcbb4f13acbe287e8fa8ebf69898a62e f9ca4f3d06f1ae7936ee8746f1dbfa1f |
Inspection has been approved. All signatures have been obtained.
Public Notes
Text: | |
File(s): |
Internal Notes
Text: | |
File(s): |