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On the North Shore of Lakc Misznetorzka ON-SITE SEWAGE TREATMENT INSPECTION REPORT � POST OFFICE BOX 66 1335 S. Brown Rd. � � � � Crystal Bay, MN 55323 473-7357 OWNER ��aY� ICC:�I� AbDR SS �Ia -� ��Sf��- �� PERMIT NO.'S. DATES CONTRACTORS ° � City Ordinance No. 210 requires that each on-site sewage treatment syste in Orono be inspected on a regular basis.The on-site sewage treatment system at the above address has been inspected and appears to fal�into he category checked below. (This is � an existing system ❑ new construction) �1 Meets or exceeds current City standards in all respects re�ating to design,construction,and iocation.Appears to be operating properly. � 2 Does not meet all current City standards for new cons�ructi n (1978 Code) but in most respects appears to be designed, located, and constructed generally in accordance with pr viou codes.System appears to be functioning properly; no major upgrading of the system is required at this time. ❑ 3 Does not meet current City standards in many respects r�Iatin to design,construction, or location.Appears to be operating adequately at this time, but has a relatively high potential for uture problems. No major upgrading of system is required at this time. � 4 System may or may not meet current City standards for desig , construction or location, but is failing to properly treat and dispose of the current input, and is endangering a water suppl , or is a source of pollution to surface or groundwaters,or is creating a safety hazard,or is otherwise creating a public nuisa ce.Please contact the City Inspector to discuss system repair/ replacement procedures. If drainfield replacement is necessary,soil testing will usually be required,and a design and site plan must be submitted for review.Your contractor must obtai�a p mit before work is started. SYSTEM CONDITION ( m Checked items may require your action) Tank inspection indicates: � ❑ I spection pipe is located directly over tank baffle.(Does not �-Pumpout not needed at this time. ive accurate measurement of solids accumulation.) If tanks ❑ Solids accumulation in tanks indicates they should be pump• ave not been pumped out within the last three years, they ed out this year to help prevent future problems. ould be pumped out now. ❑ Solids accumulation in tanks is at a critical level. Tanks Drainfi Id inspection indicates: should be pumped out as soon as possible. I � rai�field is dry,no surfacing evident. ❑ System is discharging to surface. Tanks must be pumped ❑ ome evidence of surfacing,not critical yet. within 48 hours to eliminate surface discharge. ❑ rainfield is saturated and visibly discharging untreated ❑ Inspection risers missing—tanks could not be inspected, I ffluent to the surface. This condition may require replace- Inspection risers (4" dia. pipe)must be installed in each tank ent or additions to drainfield. Contact the City Inspector at next pumpout. If tanks have not been pumped out within mediately.Repairs must be completed within 90 days. the last three years,they should be pumped out now. � ❑ rainfield extent and condition unknown. SITE CHARACTERISTICS: Limiting Site Factors Potential for System Fai ure Site Capabilities for ❑ Slope (depends on soil t pes, ater Future Expansion ❑ Soil table,and system�ondi on) ❑ Adequate �igh water table �"Low �air ❑ Lot size ❑ Medium ❑ Poor ❑ Lake,wetland,or stream 0 High ❑ Inadequate ❑ Drainage ❑System is c using visible surtace disc�arge. COMMENTS: ��'�� ,��/ �: Date of Inspection ptic System Inspector Note: In the event that this inspection report is used to satisfy the requilreme ts for a mortgage or other transfer of property,be advised that this report does not guarantee or certify that an existing system will con�tinue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available information, This report must be kept on the premises with syst m location and pumping records. WHITE COPY/ Inspector's File GOLD COPY/Homeowner