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On the North Shore o f Lake Misznetorzka ON-SITE SEWAGE TREATMENT INSPECTION REPORT � POST OFFICE BOX 66 1335 S. Brown Rd. � � � Crystal Bay, MN 55323 473-7357 owNER ��►%i �Cvn.�rir aooREss �e�� (�- �� . ��"a rs,�o,r�� PERMIT NO.'S. — DATES — CONTRACTORS —' City Ordinance No. 210 requires that each on-site sewage treatment system in Oro�o be inspected on a regular basis.The on-site sewage treatment system at the above address has been inspected and appears to fali into the category checked below. (This is � an existing system ❑ new construction) � � Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating properly. � 2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed, located, and constructed generally in accordance wiih previous 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 relating to design,construction, or location.Appears to be operating adequately at this time, but has a relatively high potential for future problems. No major upgrading of system is required at this time, � 4 System may or may noi meet current City standards for design, construction or location, but is failing to properly treat and dispose of the current input, and is endangering a water supply,or is a source of pollution to surface or groundwaters,or is creating a safety hazard,or is otherwise creating a public nuisance.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 obtain a permit before work is started. SYSTEM CONDITION ( m Checked items may require your action) Tank inspection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not ❑ Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks ❑ Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years, they ed out this year to help prevent future problems. should be pumped out now. ❑ Solids accumulation in tanks is at a critical level. Tanks Drainfield inspection indicates: should be pumped out as soon as possible. ❑ Drainfield is dry,no surfacing evident. ❑ System is discharging to surface. Tanks must be pumped ❑ Some evidence of surfacing,not critical yet. within 48 hours to eliminate surface discharge. ❑ Orainfietd is saturated and visibly discharging untreated ,�Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace- Inspection risers (4" dia. pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days. the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown. '� �� SITE CHARACTERISTICS: Limiting Site Factors Potential for System Failure Site Capabilities for ❑ Slope (depends on soil types,water Future Expansion ❑ Soil table,and system condition) � Adequate ❑ High water table ❑ Low �air ❑ Lot size �Medium LJ Poor ❑ Lake,wetland,or stream ❑ High ❑ Inadequate ❑ Drainage ❑System is causing visible surface discharge. COMMENTS: �C��.3�_`�C� / Date of Inspection Septic System Inspector Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that this report does not guarantee or certify that an existing system will continue 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 system location and pumping records. WHITE COPY/Inspector's File GOLD COPY/Homeowner