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Minnesota Pollution Control Agency (MPCA) <br /> Inspection Form for Existing Septic System <br /> DATE OF: Mav 1, 1998 at 1:30 nm WEATHER CONDITIONS: Sunnv and 72 ISTS PERMIT#2368 <br /> REASON FOR INSPECTION IDENTIFICATION <br /> O Bedroom of Bath Addition Property Owner(s) Charles H.Vass Phone <br /> O Variance Site Address 700 Big Island City Orono <br /> O Complaint Zip Code 55305 County Hennenin <br /> (X) Property Transfer Fire Number Township Name <br /> () Other Is system opened up? Y N Full Partial <br /> SYSTEM <br /> Has tank(s)ever been pumped? NO Year System Built: No Idea <br /> If yes,how often? For what reason: routinely_basement backup_sluggish plumbing_other <br /> Usage: X dwelling_other establishment X seasonal other No of Bedrooms 3 No.of occupants 6 <br /> Water use appliances:X Clothes washer X Dishwasher X Garbage disposal X Whirlpool bath X Water softener_Humidifier in furn <br /> Nearest Surface Water to system; 225 feet from which type of water; river lake stream other_ <br /> SEWER SYSTEM COMPONENTS: <br /> Tank s Tank Material Soil Treatment S s� Other <br /> 1 Septic Tanl: Fiberglass Rock trench Altemative system(type) <br /> Aerobic tank Plastic Gravelless trench _Experimental system(type) <br /> Pump tank Metal Chamber trench other(type) <br /> _Holding tank X Concrete Seepage bed Note: I could not locate the drain field,I believe the system uses <br /> X Other(brick) _Mound a seepage type tank to dispose of the waste water. <br /> At-grade <br /> Tank(s)size: 600 gallons Soil treatment area size(s): N/A square feet of absorption area <br /> COMPLIANCE INSPECTION* <br /> Is there,or has there ever been,anv evidence of: Response Ex lain <br /> Discharge of sewage to the ground surface? YES (�IyQ� <br /> Discharge of sewage to surface water? YES N <br /> A seepage pit,drywell,cesspool,or leaching pit? <� NO ����,T,r� <br /> Less than two feet of vertical se aration between the soil d` / <br /> treatment system bottom and satiu�ated soil or bedrock? YES NO �2d���h� 4�' ZG ` <br /> Sewage back up into the dwelling or other establishment? YES � <br /> Situations with the potential to immediately and adversely impact, <br /> or threaten public health or safety? YES � <br /> *if yes was answered for any of the above question,the system is failing according to Minnesota R.ch. 7080.0060. <br /> STATUS OF THE SYSTEM <br /> Based on the comnliance inspecdon conducted above the svstem status is FAILING , <br /> therefore. this document is a NOTICE OF FAILURE. <br /> CERTIFICATION <br /> I hereby certify as a state of Minnesota licensed Inspector,Designer I,or Qualified Employee that my observations recorded on this form <br /> are accurate as of the date at the top of this form for the site stated above. No determined of future hydraulic performance can be made due <br /> to unknown conditions during system construction,future water usage over the life of the system,abuse of the system,and/or inadequate <br /> maintenance all of which will adversely affect the life of the system. <br /> Dave Ho ann ( 12)467-3439 License#644 <br /> May 4, 1998 �i! :�` �`.'�,;t�`;'�;� <br /> /�� � � �� 1//G,`� � <br /> I c9�OZL� <br />