Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2786, Submission # Submission-2021-2990, UID # 35803
Status: Compliance Inspection Accepted
 

System Status

System status on date: 08/20/2021 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
27028212100094050 SALEM DR, CITY OF WOODBURY4050SALEMDRWOODBURYCITY OF WOODBURY55129KAUFER JEROME G & SHEILA JW32CLAPP-THOMSSEN SALEM MEADOWS 1ST ADD1984
Owner's representative:
Name:
Sheila Kaufer
Phone:
(651402 - 9644
Email:
sssepticsolutions@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):
Searched for surface outlet
Searched for seeping in yard/backup into home
Homeowner testimony (See Comments/Explanation)
Comments/Explanation:
Homeowner interview said they have never had a problem since they purchased in 2003.  The compliance inspection done in 2003 was compliant.

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 empty (pumped) tank(s)
Comments/Explanation:
Examined tank empty.  No cracks at time of inspection.

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: 06/01/1984

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging? Yes
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: 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:

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
SS Septic Solutions LLCL4137651-343-911714845 113th St S Hastings, MN 55033NoYesNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
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 #7256 (08/24/2021)

Charge Cost Quantity Total
Non-Taxable
added 08/24/2021 9:17 PM

$42 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 08/24/2021$42.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantShelley L. Schlomka - 08/24/2021 9:17 PM
1c13b8b8360866289956e0d1449bad19
b32b15388a51a098bc66a1e7b4d4acf1
 
#1 Compliance Inspection AcceptedSarah Borrell - 09/03/2021 1:49 PM
102b97a6b8d8d60b8b93e90b98f76c93
b9e43711b929dcdc6c333d16e4b6075e
 
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? 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:
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