Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2624, Submission # Submission-2021-2818, UID # 33978
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/02/2021 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
21029201300132728 ORIOLE AVE N, TOWN OF WEST LAKELAND2728ORIOLEAVENSTILLWATERTOWN OF WEST LAKELAND55082CERAR BRIAN M31FOXRIDGE1991
Owner's representative:
Name:
Tom Trooien
Phone:
(651439 - 7323
Email:
tomtrooien@aol.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
Excessive ponding in soil system/D-boxes
Homeowner testimony (See Comments/Explanation)

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:
Existing tank integrity assessment form 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: 05/15/1991

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:
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: 3 Decimal Feet
B. Periodically saturated soil/bedrock: 5.5 Decimal Feet
C. System separation: 2.5 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

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
All State Septic ServicesL1568651-439-732312155 Norell Ave N Stillwater, MN 55082NoNoNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: tomtrooien@aol.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 #6841 (06/02/2021)

Charge Cost Quantity Total
Non-Taxable
added 06/02/2021 8:01 AM

$42 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 06/02/2021$42.00
Due$0.00

Approvals

ApprovalSignature
ApplicantTom Trooien - 06/02/2021 8:02 AM
513cd7c44428106ab03404fcec248938
7cd2e52d8b5a0be163d1257ac0d56db7
#1 Compliance Inspection AcceptedSarah Borrell - 06/22/2021 8:24 AM
8be6437192881b02b925808facd7496f
105e0cca8d120d4f69e331cc9376bb98
Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

    Internal Notes

    Text:
    File(s):
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