SSTS Permitting Sandbox site
Compliance Inspection Compliance Inspection Compliance Inspection # CI-2016-0224, Submission # Submission-2016-0250, UID # 3753
Status: System Replaced
Status: System Replaced
System Status
System status on date: | 06/14/2016 | System Status: | Noncompliant |
System - Noncompliant
Reason(s) for noncompliance: | Impact on Public Health (Compliance Component #1) - Imminent threat to public health and safety |
Property Information
Property Information: | |||||||||||||||||
Property Owner's Mailing Address (if different than property address): |
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Owner's representative: |
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Impact on Public Health
System discharges sewage to the ground surface: |
Yes | 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 System requires "emergency" pumping Other methods not listed (See Comments/Explanation) |
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): | Other methods not listed (See Comments/Explanation) |
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: |
Yes |
Explain: | see report |
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): | Other (See Comments/Explanation) |
Comments/Explanation: | see report |
A. Bottom of distribution media: | 0 Decimal Feet |
B. Periodically saturated soil/bedrock: | 0 Decimal Feet |
C. System separation: | 0 Decimal Feet |
D. Required compliance separation: | 0 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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Certification
Inspector: |
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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 #1015 (06/24/2016)
Charge | Cost | Quantity | Total |
---|---|---|---|
added 06/24/2016 11:01 AM $40 Flat Fee |
$40.00 | x 1 | $40.00 |
Grand Total | |||
Total | $40.00 | ||
Payment 06/24/2016 | $40.00 | ||
Due | $0.00 |
Action: Print
Approvals
Approval | Signature | Options |
---|---|---|
Applicant | Brian Humpal - 06/24/2016 11:01 AM d20dd5ce18cfae041bbc5fe37bcbea93 635c5b286138af9c675e9e9636e17f46 | |
#1 Compliance Inspection Accepted | Christopher W. LeClair REHS - 06/27/2016 10:39 AM f5e264577ce3e4daf7e4553635579622 9d67bed9c3d200f938432856543a65c6 |
Inspection has been approved. All signatures have been obtained.
Text: | |
File(s): |
Text: | |
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: |