septic info - Laserfiche WebLink

Home Browse Search

s Property address: 3020 Watertown Rd,Orono Inspector initials/Date: JS 1 10/4/2017 (mm/ddlyyyy) 1. Impact on Public Health—Compliance component#1 of 5 Compliance criteria: Verification method(s): System discharges sewage to the ❑Yes ® No ®Searched for surface outlet round surface. ®Searched for seeping in yard/backup in home System discharges sewage to drain ❑Yes ® No ❑Excessive ponding in soil system/D-boxes tile or surface waters. ❑ Homeowner testimony(See CommentslExplanation) System causes sewage backup into ❑Yes ® No ❑"Black soil"above soil dispersal system dwelling or establishment. ❑System requires"emergency"pumping Any"yes"answer above indicates the ❑Performed dye test system is an imminent threat to public ❑Unable to verify(See CommentslExplanation) health and safety. ❑Other methods not listed(See CommentslExplanation) Comments/Explanation: 2. Tank Integrity—Compliance component#2 of 5 Compliance criteria: Verification method(s): System consists of a seepage pit, ❑Yes ®No ❑Probed tank(s)bottom cesspool,drywell, or leaching pit. ®Examined construction records Seepage pits meeting 7080.2550 may be ❑Examined Tank Integrity Form(Attach) compliant if allowed in local ordinance. ❑ Sewage tank(s)leak below their ❑Yes ® No Observed liquid level below operating depth designed operating depth. ®Examined empty(pumped)tanks(s) If yes,which sewage tank(s)leaks: ❑ Probed outside tank(s)for"black soil" Any"yes"answer above indicates the ❑Unable to verify(See CommentalExplanation) system is failing to protect groundwater. ❑Other methods not listed(See CommentslExplanation) Com ments/Explanation: 3. Other Compliance Conditions—Compliance component#3 of 5 a. Maintenance hole covers are damaged,cracked,unsecured,or appear to be structurally unsound. ❑Yes* ®No ❑Unknown b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. ❑Yes* ®No ❑Unknown *System is an imminent threat to public health and safety. Explain: c. System is non-protective of ground water for other conditions as determined by inspector. ❑Yes* ®No *System is failing to protect groundwater. Explain: www.pca.state.mn.us - 651-296-6300 800-657-3864 TTY 651-282.5332 or 800-657-3864 - Available in altemative formats wq-wwists4-31 • 3116112 Page 2 of 3