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3 of 11 <br /> Property address: 1235 Lyman Avenue, Orono, MN 55356 Inspector initials/Date: 5/16/20180.* <br /> 1. Impact on Public Health—Compliance component#1 of 5 <br /> Compliance criteria: Verification method(s): <br /> System discharge sewage to the ❑ Yes ® No ® Searched for surface outlet <br /> .round surface. ® Searched for seeping in yard/backup in home <br /> System discharge sewage to drain tile IDYes ® No ® Excessive ponding in soil system/D-boxes <br /> or surface waters. 111Homeowner testimony(See Comments/Explanation) <br /> ❑ "Black soil"above soil dispersal system <br /> System cause sewage backup into [' Yes ® No <br /> ❑ System requires"emergency"pumping <br /> dwelling or establishment. <br /> ❑ Performed dye test <br /> Any"yes"answer above indicates the system is ❑ Unable to verify(See Comments/Explanation) <br /> an Imminent Threat to Public Health and Safety. ® Other methods not listed (See Comments/Explanation) <br /> Comments/Explanation: <br /> According to city records,the mound surfaced in 1987 and at the time additional fill was brought in for the base of the mound. <br /> No reports of surfacing have been reported since. In addition, there are two large trees adjacent to the mound red bed and a <br /> cluster of smaller trees on the rock bed that should be cut flush to the ground,taking special care that no equipment be driven <br /> on the mound. <br /> 2. Tank Integrity—Compliance component#2 of 5 <br /> Compliance criteria: Verification method(s): <br /> System consists of a seepage pit, ❑ Yes ® No ® Probed tank(s)bottom <br /> cesspool,drywell,or leaching pit. ® Examined construction records <br /> Seepage pits meeting 7080.2550 maybe ❑ Examined Tank Integrity Form(Attach) <br /> compliant if allowed in local ordinance. <br /> Cl Observed liquid level below operating depth <br /> Sewage tank(s)leak below their ❑ Yes ® No <br /> C1Examined empty(pumped)tanks(s) <br /> desi.ned o.eratin. de.th. <br /> If yes,which sewage tank(s)leaks: ❑ Probed outside tank(s)for"black soil" <br /> ❑ Unable to verify(See Comments/Explanation) <br /> Any "yes"answer above indicates the <br /> system is Failing to Protect Groundwater. CIOther methods not listed (See Comments/Explanation) <br /> Comments/Explanation: <br /> Lowered underwater camera into tanks-baffles and tank walls OK. <br /> Although not a compliance criteria,the lift pump alarm may not be working properly. The alarm should be verified that it works <br /> and if found not working it should be replaced as soon as possible to notify the occupants of the house in the event of a pump <br /> malfunction. <br /> 3. Other Compliance Conditions—Compliance component#3 of 5 <br /> a. Maintenance hole covers are damaged, cracked, unsecured,or appear to structurally unsound. 0 Yes* ® No ❑Unknown <br /> b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. ❑Yes* ® No 0 Unknown <br /> *System is an imminent threat to public health and safety <br /> Explain: <br /> c. System is non-protective of ground water for other conditions as determined by inspector ❑Yes* ® No <br /> *System is failing to protect groundwater <br /> Explain: <br /> www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats <br /> wq-wwists4-31 • 1/24/12 Page 2 of 3 <br />