SSTS Permitting Sandbox site
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2649, Submission # Submission-2021-2847, UID # 34133
Status: Compliance Inspection Accepted
Status: Compliance Inspection Accepted
System Status
| System status on date: | 06/04/2021 | 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 |
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) |
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? | 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) |
| A. Bottom of distribution media: | 2 Decimal Feet |
| B. Periodically saturated soil/bedrock: | 5 Decimal Feet |
| C. System separation: | 3 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
| Attach Files: |
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Scan0104.pdfCertification
| 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: | sssepticsolutions@gmail.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 #6884 (06/11/2021)
| Charge | Cost | Quantity | Total |
|---|---|---|---|
| added 06/11/2021 9:44 AM $42 Flat Fee |
$42.00 | x 1 | $42.00 |
| Grand Total | |||
| Total | $42.00 | ||
| Payment 06/11/2021 | $42.00 | ||
| Due | $0.00 | ||
Action: Print
Approvals
| Approval | Signature | Options |
|---|---|---|
| Applicant | Shelley L. Schlomka - 06/11/2021 9:44 AM 923e914a04fb32d97fd3d3825dcbc8d0 8202eb45edd7b165b955f40faa98f274 | |
| #1 Compliance Inspection Accepted | Sarah Borrell - 07/01/2021 5:26 PM d12a37464de2ce1cd195b822fe493771 a5a58a002354e32ef94ed21a5fe9b36a |
Inspection has been approved. All signatures have been obtained.
| Text: | |
| File(s): |
| Text: | Permit record not on file. Cottage Grove under Washington Co. in 1999. City well? |
| File(s): |
| Compliance Letter Type: | Certificate of Compliance | Who's signature should be on the letter? | Sarah Borrell | Permit number to reference in "No Replace" letter: | |
| Was the letter sent? | Yes | Compliant/Non-Compliant: | Compliant |
| Certificate of Compliance: |
| Letter of Non-Compliance: |