Laserfiche WebLink
3310 Watertown Rd,Long Lake MN 55356 <br /> Ptopeity address: (Rob&Kristin McClanahan <br /> Inspector Initials/Date: LB 06-12 2015 <br /> 1. Impact on Public Health--Compliance component#t of 5 <br /> Compliance criteria: Verification method(s): <br /> System discharge sewage to the ❑Yes [j No ❑ Searched for surface outlet <br /> round surfaos. Q Searched for seeping in yard/backup in home <br /> System discharge sewage to drain file ❑Yes ❑No ❑ Excessive ponding in soil system/0-boxes <br /> or surface waters. 0 Homeowner testimony(See Commentsexplanatfon) <br /> System cause sewage backup into ❑Yes [:]No ❑ "Black soil"above soil dispersal system <br /> dwelling or establishment. ❑ System requires"emergency"pumping <br /> Any"yes"answer above Indicates the system is ❑ Performed dye test <br /> an Imminent Threat to Public Health and Safety. Unable to verify(See CommentafxplaneNon) <br /> ❑ Other methods not listed(See Commentsl,Explanatlon) <br /> Comments/Explanation: <br /> 2. Tank Integrity—Compliance component#2 of 5 <br /> Compliance criteria: Verification method(s): <br /> System consists of a seepage pit, ❑Yes Eft ❑ Probed tank(s)bottom <br /> cesspool,drywall,or leaching pit. ( " ❑ Examined construction records <br /> Seepage pits meedng 7080.2WO may be ❑ Examined Tank Integrity Form(Attach) <br /> COMP(lant 9 allowed In local or+dlnanoe. <br /> ❑ Observed liquid level below operating depth <br /> Sewage tank(&)leak below their ❑Yes ej�bWo ® Examined empty(pumped)tanks <br /> designed o eratin <br /> depth. (s) <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 CommentwExplanatlon) <br /> system Is Failing to Protect Groundwater. ❑Other methods not listed(See Comment&-Expianatlon) <br /> Comments/Explanation: „ (�0,0 q a --�-.0 *'s ! CC o� <br /> Je,6"V <br /> Business Name: Kothrade Sewer,Water,Excavating,Inc <br /> Business Address: 12059 Whitetail Ln,Hanover MN 55341 <br /> Business Phone: 763.498.8702 <br /> Company Representative: LarryBursch MPCA#: 0192/9199 Signature aL <br /> 3. Other Compliance Conditions—Compliance component#3 of 5 <br /> a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. ❑Yes* ❑No ❑Unknown <br /> b. Other Issues(eleobtoal hazards,eta.)to Immediately and adversely impact public health or safety. ❑Yes* ❑No ❑Unknown <br /> *System Is an lmmimmt threat to public health and safety <br /> Explain: <br /> c. System Is non-protective of ground water for other conditions as determined by inspector ❑Yes• ❑No <br /> *System Is falling to protect groundwater <br /> www.pca.state.mn.us " 651-296-6300 • 800-657-3864 TTY 651-282-5332 or 800.657-3864 • Available In alternative formats <br /> wq-wwlsts4.31 • 1124112 Page 2 of 4 <br />