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MINNESOTA POLLUTION Com flcrice inspection Y CONTROL AGENCY p p ction report form <br />520 Lafayette Road North Existing Subsurface Sewage Treatment System (SSTS) <br />St. Paul, MN 55155-4194 Doc Type: Compliance and Enforcement <br />Instructions: Inspector must submit completed form to Local Governmental Unit (LGU) and system owner within 15 days of <br />final determination of compliance or noncompliance. Instructions for filling out this form are located on the Minnesota Pollution <br />Control Agency (MPCA) website at https://www.oca.state.mn us/sites/default/files/wq-wwists4-31a odf. <br />Property information Local tracking number: <br />Parcel ID# or Sec/Twp/Range: 0511723430005 Reason for Inspection Property Transfer <br />Local regulatory authority info: City Of Orono, (9.52) 249-4600 i <br />Property address: 3400 Fox Street, Orono <br />Owner/representative: Bill Hohenecker _ Owner's phone: 612-704-3538 <br />Brief system description: 2 -1500 -gallon septic tanks, 1-1000 gallon septic tank and 1 -1500 -gallon lift station and 1120 Square feet <br />Rock bed per City records <br />System status <br />System status on date (mmldd/yyyy): 9/6/2022 <br />❑ Compliant— Certificate of compliance* <br />(Valid for 3 years from report date unless evidence of an <br />imminent threat to public health or safety requiring removal and <br />abatement under section 145A.04, subdivision 6 is discovered or <br />a shorter time frame exists in Local Ordinance.) <br />0 Noncompliant— Notice of noncompliance <br />Systems failing to protect ground water must be upgraded, replaced, or <br />use discontinued within the time required by local ordinance. <br />An imminent threat to public health and safety (I TPNS) must be <br />*Note: Compliance indicates conformance with Minn. upgraded, replaced, or its use discontinued within len months of receipt <br />of this notice or within a shorter period if required by local ordinance or <br />R. 7080.1500 as of system status date above and does not under section 145A.04 subdivision 8, <br />guarantee future performance. <br />Reason(s) for noncompliance (check all applicable) <br />❑ Impact on public health (Compliance component #1) — imminent threat to public health and safety <br />® Tank integrity (Compliance component #2) — Failing to protect groundwater <br />D Other Compliance Conditions (Compliance component #3) — Imminent threat to public health and safety <br />❑ Other Compliance Conditions (Compliance component #3) — Failing to protect groundwater <br />❑ System not abandoned according to Minn. R. 7080.2500 (Compliance component #3) — Failing to protect groundwater <br />❑ Soil separation (Compliance component #5) — Failing to protect groundwater <br />❑ Operating Permit/monitoring plan requirements (Compliance component #4) — Noncompliant - local ordinance applies <br />Comments or recommendations <br />The system is designed for a nine bedroom house. <br />There is 1,0 feet of sand under the uphill side of the rock bed as per the inspection. I found 1.5 feet of sand. <br />The existing Ifit station is corroded and will need to be replaced. <br />When the tanks have been replaced. The system will be compliant. The existing Mound system meet the separation <br />requirments. <br />Certification <br />i hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of <br />future system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, <br />inadequate maintenance, or future water usage. <br />8y typing my name below, 1 certify the above statements to be true and correct to the best of my knowledge, and that this information can be <br />used for the purpose of processing this form. <br />Business name: Rusty Olson Soil & percolation T <br />Inspector signature: Joseph J. Olson <br />(This document has been electronically signed) <br />Certification number: 01255 <br />License number: L810 <br />Necessary or locally required supporting documentation (must be attached) <br />Phone: 763-498-8779 <br />Soil observation logs M System/As-Built ❑ Locally required forms ® Tank Integrity Assessment ❑ Operating Permit <br />El Other information (list): <br />https://www.pca.state.mn.us 651-256-6300 • 800-657-3864 • Use your preferred relay service • Available in alternative formats <br />wq-wwists4-31b • 4/28/2021 Page 1 of 4 <br />