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Jan 28 14 05:34p Joseph Olson 763-498-8290 p.3 <br /> Property address: 4245 Sa �de Road,Orono,MN inspectoe initialslDate: J.O. 1/16/14 <br /> i. impact or� Public Hed(th—Compliance component#1 of 5 <br /> _Compliance criteria: _ VerificatioR method(s): <br /> System discharge sewage to the ❑Yes �No � Searched for surface ovtlet <br /> ground surface, � Searcfted fior seepiRg in yardJbackup in home <br /> System discharge sewage So drain tile ❑Yes � No ❑ �cessive ponding in soil systemlD-boxes <br /> or sUrface waters. � Homeowner testimony(Sea Comments/F�planation) <br /> System cause sewage backup into ❑Yes ❑ "slack soil'above soiE dispersal system <br /> dwelfing or establishment. <br /> � N° ❑ System requires"emergenc�l'pumping <br /> Performed dye test <br /> Any"yes"answer above indicates the system is Unable to verify(see Commer�ts�cptanason) <br /> an lmminen�Threaf fo Pub�ic Health and Safety. Other methods not listed(see cvmments�cpranation} <br /> CommerttslExpla nation: <br /> 2. Tdnk Int2�r'ity—Compliance corrzponent#2 of 5 <br /> _Compliance cnteria: erification method(s): <br /> System consists of a seepage pit, ❑Yes � No Prabed tank(s)bottom <br /> cesspool,drywell,or leaching pit. Examined construction records <br /> Seepage pifs m�eting 7080.2550 may 6e ' Examined�ank integr�ty Form(Attach) <br /> com fiant if aAowed in local ordinance. <br /> Observed liq�id level below operating depth <br /> Sewage 2ank(s�feak below their ❑Yes �No F�camined empty{pumped)tanks(s) <br /> designed operafin4 depth. <br /> If yes,which sewage tank(s} leaks: Probed outside tank(s)for"black soil" <br /> Any "yes"8rlsvYef BboVe 1I�diCateS the Unable to verify(5ee Comments/Explanatiort) <br /> sys�em is Failing fo Protecf Groundwater. �her r7lethods not listed(5ee CommentsiExplanalionJ <br /> Co m me n tslE xpla n at io n: <br /> Petersan Comparry pumped the tanks <br /> 3. dther Compltante Conditions—Compliance component of 5 <br /> a. Maintenas�ce hole cavers are damaged,craciced,unsecured,or a� to structurally unsound. ❑Yes' �nlo ❑Unknown <br /> b. Otl�er issues[efeclrical hazarris,etc.)to imme�ately and adversely impa publiC heatth or safety_ ❑Yes" �No ❑Unknown <br /> �'Sys(em is an imrninent threat i�public heafth and saiety <br /> Exp(ain_ <br /> c. S7rstem is non-protec#ive of ground water for other conditions as cfete ined by inspecEor ❑Yes� �No <br /> "`Syrstem es fariing i�o praiect groundwater <br /> Expfain: <br /> www_ptastate.mn.us - 651-296-6300 • 80p-657-3864 • 77Y 651-282 5332 or 8D0-657-3864 • Availahle in altemative formats <br /> wq-wwists4-31 - f l24!72 <br /> Page 2 of 3 <br />