05/16/18 Septic Compliance Inspection

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Inspect Minnesota eMidwest Soil Testing Subsurface Sewage Treatment System Owner/Property Information This information will be used for the purpose of conducting an MPCA Compliance Inspection. Date of Inspection: May 16, 2018 Time: 9:15 AM Property Address: 1235 Lyman Avenue, Orono, MN Zip: 55356 Property Owner: Paul Pesek Phone: Tank(s) Tank(s)Material Soil Treatment System Other ®Septic 2 ❑Fiberglass ❑Rock trench ❑Alternative system DAerobic ['Plastic ❑Gravelless trench ['Experimental system ®Lift ❑Metal ['Chamber trench DCesspool system DHolding ®Concrete ❑Seepage bed DOther system ❑Other: ❑Block ®Mound ❑Other DAt-grade Are the tank maintenance covers accessible? ®Yes ❑No *If no,proper maintenance must be performed through the maintenance holes. Maintenance hole covers should be made accessible to the ground surface to facilitate access and proper maintenance of the system. Year house built: 1984 Year septic installed: 1984 Tank size (gals.): 2-1000 How long has seller owned the property? Number of residents in home? Number of bedrooms? 5 r Are all floors drained by gravity? Y Garbage disposal? Whirlpool bath? More than one system(laundry, etc.)? Does this property have any footing drain tiles connected to the septic system? Are any buildings on this property such as garages or out-buildings connected to this system? Are there any additional systems on this property serving other buildings? Location of septic system on lot? South Side Location of water well on lot?Northwest Side Is the well a deep well?Y Have you ever experienced any problems with the system such as: tree roots, sewage back-ups, surfacing of sewage onto the ground, septic tank overflowing, etc.; or have any repairs been made to the system? If yes, explain: When was the system last pumped? April 25? Name of pumper: Unknown How often pumped in previous years? Every 3 Is system on a monitoring plan? Have you received notices from any government agency concerning this system? Is your property located in a shoreland management area?N Do you have any additional information that should be given to the new owner? I hereby certify that the above information is correct to the best of my knowledge. I also understand that if the system is considered"non-compliant/failing"per MPCA rules, that the inspector must by law submit a copy of this report to the local government unit within 15 days of the date of inspection completion. I also agree that unless otherwise noted in this report,that I/we are ultimately responsible for payment of all fees for all work performed relative to this inspection by Inspect Minnesota and Midwest Soil Testing. Owner/Occupant: Date: