SSTS Permitting Sandbox site
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2487, Submission # Submission-2021-2677, UID # 32947
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 02/25/2021 | System Status: | Compliant |
Property Information
| Property Information: | |||||||||||||||||
| 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 Other methods not listed (See Comments/Explanation) |
Comments/Explanation: | Visual Inspection |
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) |
| Comments/Explanation: | Tank Intergrity form is attached |
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: | 01/01/1986 |
Soil Separation
| Shoreland/Wellhead Protection/Food, beverage, lodging? | No |
| Drainfield has at least a two-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) |
| A. Bottom of distribution media: | 2.6 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 4.8 Decimal Feet |
| C. System separation: | 2.2 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
| Comments or recommendations: | See attached report |
| Attach Files: |
KSD_SSTS_INSPECTION_9610_Dellwood_Road_Mahtomedi_Ver_1.0_2-25-21.pdfCertification
| Inspector: |
Please search for and choose SELF/OTHER if what you need does not appear in the list
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| Inspector Contact (If 'self/other' is selected from the Inspector Lookup): | Jesse Kloeppner |
| Inspector Email Address: | jesse@ksd-mn.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 #6514 (03/11/2021)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 03/11/2021 10:16 AM $42 Flat Fee |
$42.00 | x 1 | $42.00 |
| Grand Total | |||
| Total | $42.00 | ||
| Payment 03/11/2021 | $42.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Jesse J. Kloeppner - 03/29/2021 11:37 AM c26a5af0ee49907f88b82bb58f757b26 3b2e0d8d44e57ca93be6377081f3c90e | |
| #1 Compliance Inspection Accepted | Tyler Dale - 04/05/2021 8:46 AM 93b91967ad3257e5e93f2574fd1a6bd3 d35e065f28faf8160b55587d9570a5ab |
Inspection has been approved. All signatures have been obtained.
| Text: | |
| File(s): |
| Text: | |
| File(s): |
| Compliance Letter Type: | Certificate of Compliance | Who's signature should be on the letter? | Tyler Dale | Permit number to reference in "No Replace" letter: | |
| Was the letter sent? | Yes | Compliant/Non-Compliant: | Compliant |
| Certificate of Compliance: |
| Letter of Non-Compliance: |