Laserfiche WebLink
Property address: 150 North Shore Dr. W Orono MN Inspector initials/Date: 1 1 91M018 <br />(mmkid1yM) <br />1. Impact on Public Health — Compliance comQonent #1 of 5 <br />System discharges sewage to the I ❑ Yes ® No <br />System discharges sewage to drain I C] Yes ® No <br />System causes sewage backup into I ❑ Yes ® No <br />dwelling or establishment. 1 <br />Any "yes" answer above indicates the <br />system is an imminent threat to public <br />health and safety. <br />Comments/Explanation: <br />2. Tank Integrity — Compliance component #2 of 5 <br />ice criteria: <br />System consists of a seepage pit, ❑ Yes ® No <br />cesspool, drywell, or teaching pit. <br />Seepage pits meeting 7080.2550 may be <br />cwwAant if allowed in kcal ordinance. <br />Sewage tank(s) leak below their 0 Yes ® No <br />designed operating depth. <br />If yes, which sewage tank(s) leaks: <br />Any "yes" answer above indicates the <br />system is failing to protect groundwater. <br />Comments/Explanation: <br />Verification method(s): <br />❑ Searched for surface outlet <br />® Searched for seeping in yard/backup in home <br />❑ Excessive ponding in soil system/D-boxes <br />❑ Homeowner testimony (see CommentsExptanation) <br />F-1 "Black soil" above soil dispersal system <br />❑ System requires "emergency" pumping <br />❑ Performed dye test <br />❑ Unable to verify (See CommenWExpAwatbn) <br />❑ Other methods not listed (See Commenbl&pianation) <br />Verification method(s): <br />❑ Probed tank(s) bottom <br />❑ Examined construction records <br />❑ Examined Tank Integrity Form (Attach) <br />❑ Observed liquid level below operating depth <br />® Examined empty (pumped) tanks(s) <br />❑ Probed outside tank(s) for "black soil" <br />❑ Unable to verify (See CommenW&planatbn) <br />❑ Other methods not listed (See CommenWExplanatbn) <br />3. Other Compliance Conditions -- Compliance component_#3 of 5 <br />a. Maintenance hole covers are damaged, cracked, unsecured, or appear to be structurally unsound. O Yes" ® No D Unknown <br />b. Other issues (ebcftWhazan*, eic.) to immediately and adversely impact public health or safety. ❑ YW R No ❑ Unknown <br />'System is an jmm&ww threat to public health and safety. <br />Explain: <br />c. System is non -protective of ground water for other conditions as determined by inspector. CI Yes" ® No <br />"System is WAIV to protectWwndWater. <br />Explain: <br />www.pca.state.mn.us • 651-2%-6300 • 800.657-3864 TTY 651-282-5332 or 800.657-3864 • Available in alternative formats <br />wq-wwlsts4-31b • 614114 Page 2 of 3 <br />