Laserfiche WebLink
Dec 1812 04:05p Joseph Olson 763-498-8290 p,5 <br /> Property address: 3743 Watertown Road <br /> _ Inspector initialslDate: 4127112 <br /> 1. Impact on Public Health –Compliance component#1 of 5 <br /> Compliance criteria: _ _ Verification method(s): <br /> System discharge sewage to the I ❑ Ye5 ❑ No ❑ Searched for surface outlet <br /> ground surface, I _ ❑ Searched for seeping in yard/backup in home <br /> System discharge sewage to drain tile ❑ Yes ❑ No ❑ Excessive ponding in soil system/D-boxes <br /> or surface waters. ❑ Homeowner testimony(See commenLv&p/aneticn) <br /> System cause sewage backup into ❑Yes Q No ❑ 'Black soil"above soil dispersal system <br /> dwelling or establishment. I ❑ System requires'emergency,pumping <br /> Any"Yes"Wswer above indicates the system is C Performed dye test <br /> an Imminent Threat to public Health and Safety. ❑ Unable to verify (See CommenfslExplanation; <br /> ❑ Other methods not listed(see CommenfsJExplanatroy <br /> Comments/Explanation: <br /> 2. Tank Integrity—Complianc( component#2 of 5 <br /> Compliance criteria: _ i Verification method(s): <br /> System consists of a seepage pit, I ❑Yes ® No ❑ Probed tank(s)bottom <br /> cesspool, drywell, o.leaching pit Examined construction records <br /> Seepage pits meeting 7080.2550 rrray�e I ❑ Examined Tank integrity Form(Attach) <br /> compliant if aftowed in local ordinance. <br /> Sewage tank(s)leak below their ; ❑ Yes No <br /> Observed liquid level below operating depth <br /> designed operating depth._ ® Examined empty(pumped)tanks(s) <br /> If yesw <br /> , hich sewage tank(s)leaks:' Q Probed outside tank(s)for"black soil" <br /> Any "Y�"answer abovre i diCates the ❑ Unable to verify(Sea CommnfsiExpfanauon) <br /> _system is Failing to Protect Groundwater. ❑ Other methods not listed (See Commenfsl�xplanaf on) <br /> Comments/Explanation: <br /> On 4/27112, Elmer J. Peterson Co. umped septic tanks and cleaned2nd filter in 2 tank. No cracks or water leaks at that time. <br /> 3. Other Compliance Conditions—Compliance component#3 of 5 <br /> a. Maintenance hole covers are damaged,cracked, unsecured, or appear to structurally unsound. —0Yee ®No O Unknown <br /> b. Other issues(elecMcai hazards,etc.)to immediately and adversely impact public health or <br /> "System is an Imminent to public health and safety <br /> ❑Yes• p No p Unlmown <br /> nt tht <br /> Explain: <br /> c. System is non-protective of ground water for other conditions as determined by inspector 0 Year 0 No <br /> •Systey►►is failing to protect groundwater <br /> Explain: <br /> www.pcs.state.mn.us 651.246-6300 800-657-3864 TTY 651-282-5332 or 800-657.3864 <br /> ,,rq-wwisls4-j f • 112411Z Available in alternative formats <br /> Page 2 of 3 <br />