Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2734, Submission # Submission-2021-2788, UID # 33775
Status: Replacement Extension Granted
 

System Status

System status on date: 05/10/2021 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
24029211200052955 LEGION AVE N, CITY OF LAKE ELMO2955LEGIONAVENLAKE ELMOCITY OF LAKE ELMO55042STEVENS FLORAIN J & CYNTHIA1966
Owner's representative:
Name:
Cindy Stevens
Phone:
(651303 - 2346
Email:
noalarmday@gmail.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):
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):
Other methods not listed (See Comments/Explanation)
Comments/Explanation:
Visual Inspection of tanks after emptied by Pinky's Sewer. Risers may need to be replaced or repaired due to slight soil intrusion at seems of 12" sections of risers.

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):
Other (See Comments/Explanation)
Comments/Explanation:
Visual Inspection
A. Bottom of distribution media: 2.5 Decimal Feet
B. Periodically saturated soil/bedrock: 1.7 Decimal Feet
C. System separation: -.8 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:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
SELF/OTHERn/an/an/a
Please search for and choose SELF/OTHER if what you need does not appear in the list
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 #6782 (05/19/2021)

Charge Cost Quantity Total
Non-Taxable
added 05/19/2021 3:55 PM

$42 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 05/19/2021$42.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantJesse J. Kloeppner - 05/19/2021 3:55 PM
1bf3246bba05e543332663e78e2b1899
c32df11924b137c49b4c3e613450c46d
 
#1 Compliance Inspection AcceptedSarah Borrell - 08/02/2021 11:54 AM
f2e4ca8420125fb73970a993d2d2a6de
8c5f08ca4dc84738ac641177d8149f99
 
Inspection has been approved. All signatures have been obtained.
Text:
See attached.
File(s):
Text:
File(s):
    Compliance Letter Type: Failed System, Notice and Order to Comply, Separation Who's signature should be on the letter? Joe Sanders Permit number to reference in "No Replace" letter:
    Was the letter sent? Yes Compliant/Non-Compliant: Noncompliant
    Certificate of Compliance:
      Letter of Non-Compliance:
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