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Property address: 2915 Somerset Lane,Orono,MN Inspector initials/Date: J.O.8/08/18 <br /> 1. impatt on Public Health —Compliance component#1 of 5 <br /> Compliance_criteria: Verification method(s�: <br /> - ---- -� � � <br /> System discharge sewage to the ❑Yes �No � Searched for surface outlet <br /> rg ound surtace. ___ _� _ � Searched for seeping in yardlbackup in home <br /> System discharge sewage to drain tile ❑Yes �No � ��ssive ponding in soil system/D-boxes <br /> or surface waters. I ❑ Homeowner testimony(See Comments/Explenadon) <br /> _ - --- <br /> System cause sewage backup into � ❑Yes �No ❑ "Black soil°above soil dispersal system <br /> dwelling or establishment. j ❑ System requires"emergency"pumping <br /> --- -- �- ❑ Performed dye test <br /> Any"yes"answer above/ndicates the system is ❑ Unable to verify(See CommentsiExp/anation) <br /> an Imminent Threat to Public Heafth and Safety. ❑ Other methods not listed(see commenrs�xp�anariar� <br /> Comments/Explanation: <br /> 2. Td11k Integr'ity—Compliance component#2 of 5 <br /> Compliance criteria: _ Verificatlon method(s): <br /> System consists of a seepage pit, ; ❑Yes �No ❑ Probed tank(s)bottom <br /> cesspool,drywell,or leaching pit. j ❑ Examined construction records <br /> Seepege pits meeting 7080.2550 may be i ❑ Examined Tank Integrity Form(Attach) <br /> comdient if elbwed in local ordinance. <br /> - - ❑ Observed liquid level below operating depth <br /> Sewage tank(s)leak below their ' ❑Yes �No <br /> _designed operating_depth. ❑ Examined empty(pumped)tanks(s) <br /> ---�- _ _ <br /> If yes,which sewage tank(s)leaks: Probed outside tank(s)for"black soil° <br /> Any "yes"answer above indicates the ❑ Unable to verify(See Comments/Exp/anation) <br /> system is Failing to Protect Groundwater. �aher methods not listed(See Comments/Exp►anetion) <br /> Comments/Explanation: <br /> Elmer J Peterson Company pumped the tanks. <br /> 3. Othe�COmplidnCe Conditlons—Compliance component#3 of 5 <br /> a. Mairnenance hole�vers are damaged,cxacked,unsea�red,or appear to struc�urally unsound. p Yes• �No p Unkno�m <br /> b. Other issues(e/ecdical hazards,etc.)to im�diately and adversely impad public heaKh or safety. O Yes" �No O Unknown <br /> "System is an imminent tlirest to puWic hea/th and safety <br /> Explain: <br /> c. System is non-protective of ground water for other conditi�s as determined by inspecc:tor ❑Yes• �No <br /> *System/s fa!ling 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 altemative formats <br /> wq-ww;sts4-3f . f/24/12 Paqe 2 of 3 <br />