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03-15-2023 Septic Compliance inspection report
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03-15-2023 Septic Compliance inspection report
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Last modified
8/22/2023 5:16:09 PM
Creation date
3/16/2023 8:46:51 AM
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x Address Old
House Number
3415
Street Name
High
Street Type
Lane
Address
3415 High La
Document Type
Septic
PIN
0511723120017
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Updated
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Property Address: 3415 High Lane <br />Business Name: Rusty Olson Soil &percolation Testing Date: 03/15/2023 <br />1. Impact on public health — Compliance component #1 of 5 <br />Com liance criteria: <br />System discharges sewage to the ❑ Yes* ®No <br />ground surface <br />System discharges sewage to drain ❑ Yes* ® No <br />tile or surface waters. <br />System causes sewage backup into []Yes* ® No <br />dwellingor establishment. <br />Any "yes" answer above indicates the system is an <br />imminent threat to public health and safet . <br />Describe verification methods and results: <br />Visual. Nothing was found <br />Attached supporting documentation: <br />❑ Other: <br />® Not applicable <br />2. Tank integrity — Compliance component #2 of 5 <br />Compliance criteria: <br />System consists of a seepage pit, ❑ Yes* ® No <br />cesspool, drywell, leaching pit, <br />or other it? <br />Sewage tank(s) leak below their ❑ Yes" ® No <br />designed operating depth? <br />If yes, which sewage tanks leaks: <br />Any "yes" answer above indicates the system <br />is failing to protect groundwater. <br />Describe verification methods and results: <br />Elmer J. Peterson Company pumped the tanks. <br />Attached supporting documentation: <br />❑ Empty tank(s) viewed by inspector <br />Name of maintenance business: <br />License number of maintenance business: <br />Date of maintenance: <br />® Existing tank integrity assessment (Attach) <br />Date of maintenance 3/8/2023 _ <br />(mmlddlyyyy): (must be within three years) <br />(See form instructions to ensure assessment complies with <br />Minn. R. 7082.0700 subp. 4 B (1)) <br />❑ Tank is Noncompliant (pumping not necessary - explain below) <br />❑ Other: <br />https://www.pca.state,mn.us 651-296-6300 800-657-3864 • Use your preferred relay service Available in alternative formats <br />wg-wwists4-31b • 4/28/2021 Page 2 of 5 <br />
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