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Minnesota Pollution Compliance Inspection For <br /> Control Agency <br /> Control <br /> Road North Existing Subsurface Sewage Treatment Systems (SST <br /> ) <br /> StPauL,MN SS1S5-4194 Doc Type:Compliance and Enforcer nt <br /> Inspection results based on Minnesota Pollution Control Agency(MPCA) For local tracking purposes: <br /> requirements and attached forms—additional local requirements may also appy. <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): April 20, 2018 <br /> ® Compliant—Certificate of Compliance ❑ Noncompliant— Notice of Noncomplian e <br /> (Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3.) <br /> frame outlined in Local Ordinance.) <br /> Reason(s)for noncompl lance(check all applicable) <br /> ❑ Impact on Public Health (Compliance Component 01)—Imminent threat to public health and safety <br /> ❑Other Compliance Conditions(Compliance Component#3)—Imminent threat to public health and safety <br /> ❑Tank Integrity(Compliance Component#2)—Failing to protect groundwater <br /> ❑Other Compliance Conditions(Compliance Component#3)—Failing to protect groundwater <br /> ❑Soil Separation(Compliance Component#4)—Failing to protect groundwater <br /> ❑Operating permit/monitoring plan requirements(Compliance Component#5)—Noncompliant <br /> Property Information Parcel ID#or Sec/Twp/Range: PID# 31-118-23-24-0013 <br /> Property address: 465 Tumham Road Orono,MN.55359 Reason for inspection: Property Transfer <br /> Property owner. Owner's phone: <br /> or <br /> Owner's representative: Edina Realty attn:Bruce&Sue Wolf Representative phone: 612 270-2220 <br /> Local regulatory authority: City of Orono Regulatory authority phone: 952 249-4625 <br /> Brief system description: A 1250 gal Septic,a 1000 gal Septic,a 1000 gal Pum (Tanks), &a 50 ft x 100ft Pressure Mound <br /> Comments or recommendations: <br /> See sketch for Configuration:-1 0 ft x 53 ft Rods Bed <br /> Consulted Constuction&AS-BUILT Data from LGU files <br /> Certification <br /> I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No <br /> determination of future system performance has been nor can be made due to unknown conditions during system construction, <br /> possible abuse of the system,Inadequate malntenance, or future water uaage. <br /> Inspector name: Thomas Klanchnik Certification number: R 5945 <br /> Business name: Advanced OnSite, Inc. License number: L 2656 <br /> Inspector signature: Phone number: 612 232-9737 <br /> Necessary or Locally Req red Attachments <br /> ® Soil boring logs ®System/As-built drawing ® Forms per local ordinance <br /> ®Other information(list): Pumping Data <br /> www.pca.state.mn.us • 651-296-6300 • 800-657-3864 TTY 651-282-5332 or 800-657-3864 • Available in altemative rmats <br /> wq.ww1sts4-31b • 614114 PaSe 1 of 3 <br />