Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2634, Submission # Submission-2021-2826, UID # 34042
Status: Compliance Inspection Accepted
 

System Status

System status on date: 05/17/2021 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
290272144000510870 IDEAL AVE S, CITY OF COTTAGE GROVE10870IDEALAVESCOTTAGE GROVECITY OF COTTAGE GROVE55016SULLIVAN PROPERTY INVESTMENTS III LLC
Owner's representative:
Name:
Joe Brockman
Phone:
(651436 - 6519
Email:
joe@brockmantrailers.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
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 Tank Integrity Form (Attach)
Comments/Explanation:
see report

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.:
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)
Comments/Explanation:
see report
A. Bottom of distribution media: 95.92 Decimal Feet
B. Periodically saturated soil/bedrock: 92.9 Decimal Feet
C. System separation: 3.02 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

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
Ten Thirty Environmental Solutions, SBCL4082612-248-42811684 132nd Ave NE Blaine, MN 55449NoNoYesYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: alex.pepin@tenthirtyenvironmental.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 #6859 (06/06/2021)

Charge Cost Quantity Total
Non-Taxable
added 06/06/2021 3:31 PM

$42 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 06/06/2021$42.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantAlex Pepin - 06/06/2021 3:31 PM
f348e05953e879c373a645724feb2612
2fe90c6ededaa38a69e94053d25a6c6c
 
#1 Compliance Inspection AcceptedSarah Borrell - 06/28/2021 6:50 AM
3035a1e73d5ee11415547d2e4b28f6a2
ef4b8bb055c409ef8fe7c9fa1b94f748
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    Email inspector about 2 separate systems. HT not designed to hold sewage.
    File(s):
    Compliance Letter Type: Who's signature should be on the letter? Permit number to reference in "No Replace" letter:
    Was the letter sent? Compliant/Non-Compliant:
    Certificate of Compliance:
      Letter of Non-Compliance:
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