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r <br /> �,�� Minnesota Pollution CO1�'lp�ldl'1Ce �IISpC'Ct101�1 FOrI'1'1 <br /> �' � Control Agency <br /> 520 Lafayette Road North Existing Subsurface Sewage Treatment Systems (SSTS) <br /> St.Pdu1,MN 55155-4144 Doc Type:Compliance and Enforcement <br /> Inspection results based on Minnesota Pollution Control Agency(MPCA) For local tracking purposes: <br /> requirements and attached forms—additional local requirements may also apply. <br /> Submit completed form to Local Unit of Government(LUG)and system owner <br /> within 15 days <br /> System Status <br /> System status on date(mm/dd/yyyy): 2l22/2017 <br /> ❑ Compliant— Certificate of Compliance � Noncompliant— Notice of Noncompliance <br /> (Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3.) <br /> frame ouUined in Local Ordinance.) <br /> Reason(s)for noncompliance(check all applicable) <br /> ❑ Impact on Public Health(Compliance Component#1)—lmminenf threat to public health and safety <br /> ❑ Other Compliance Conditions(Compliance Componenf#3)—Cmminent threat to public health and safety <br /> ❑Tank Integrity(Compliance Component#2)—Failing to protect groundwater <br /> ❑ Other Compliance Conditions(Compliance Component#3)—Failing fo protect groundwater <br /> � Soil Separation(Compliance Component#4)—Failing to profect groundwater <br /> ❑ Operating permit/monitoring plan requirements(Compliance Gomponent#5)—Noncomplianf <br /> Property Information Parcel ID#or Secll'wp/Range: 25-118-23-33-0008 <br /> Property address: 625 Spring Hill Rd,Orono Reason for inspection: Property Transfer <br /> Property owner: Owner's phone: <br /> or <br /> Owner's representative: John McWhite Representative phone: 612-805-1577 <br /> Local regulatory authority: City of Orono Regulatory authority phone: <br /> Brief system description: (2) 1000 gallon septic tanks, and rock trench drainfield. <br /> Comments or recommendations: <br /> Existing system will need to be up-graded to current city codes,as the drainfield does not meet the 3 foot seperation from a <br /> seasonal watertable. <br /> Certification <br /> 1 hereby certify that all the necessary information has been gathered to deterrnine the compliance status of this system. No <br /> defermination of future system performance has been nor can be made due to unknown conditions during system construction, <br /> possible abuse of the system,inadequate maintenance, or future water usage. <br /> Inspector name: Pernel" " ent es Certification number: <br /> Business name: Chi e tic Servi es LLC License number: 2064 <br /> Inspector signature: - ,,_� Phone number: 952-200-3176 <br /> Necessary or Locally Required Attachments <br /> ❑ Soil boring logs �System/As-built drawing ❑ Forms per local ordinance <br /> ❑ Other information (list): <br /> www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TT`(651-282-5332 or 800-657-3864 • Available in alternative formats <br /> wq-wwtsts4-31 • 3/i6/12 Page 1 of 3 <br />