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ON-SITE SEWAGE TREATMENT <br />INSPECTION REPORT <br />On the .North Shore of <br />Lake Nlinnetonka <br />POST OFFICE BOX 66 <br />1335 S. Brown Rd. <br />Crystal Bay, MN 55323 <br />473-7357 <br />OWNER C(.IrC i1S� _Qc1gDy _ADDRESS <br />PHONE <br />PERMIT NO'S. <br />DATES <br />QB <br />City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis. <br />The on-site sewage treatment system at the above address has been inspected and appears to fall into the category checked <br />below: <br />Elmeetsor exceeds current city standards in all respects relating to design, construction, and location. Appears <br />to be operating properly. <br />Does not meet current city standards in some respects relating to design, construction, or location. Appears <br />to be operating properly. <br />ElA Does not meet current city standards in many respects relating to design, construction, or location. Appears <br />s to be operating adequately. <br />Does not meet current city standards of design, construction or location, is being overused, or is failing to <br />04 properly treat and dispose of the current input and is therefore endangering a water supply, is a source of <br />pollution to surface or groundwaters, is creating a safety hazard, or is otherwise creating a public nuisance. <br />Flease contact the inspector to discuss requirements for repairs to your system. Soil testing may be re- <br />quired. In all cases a design and site plan must be submitted for review. Your contrzctor must obtain a permit <br />before work is started. <br />WORK REQUIRED: <br />ElSeptic tanks must be pumped within 48 hours. <br />Drainfield must be repaired or replaced within 90 days. <br />Inspection riser (4" diam. pipe) must be installed in each tank. Oe_ <br />F1Tank <br />inspection <br />indicates <br />maintenance pumpout is needed as soon as possible. City ordinance requires that <br />tanks <br />be pumped <br />out every <br />three years. <br />SITE CHARACTERISTICS: <br />Limiting Site Factors <br />❑ Slope <br />❑ Soil <br />❑High water table <br />,Lot size <br />❑ Lake, wetland, or stream <br />Drainage <br />COMMENTS: <br />Date of Inspection <br />Potential for System Failure <br />(depends on soil types, water <br />table, and system condition) <br />❑ Low <br />Omedium <br />High <br />❑ System is causing visible <br />surface discharge. <br />Site Capabilities for <br />Future Expansion <br />❑ Adequate <br />❑ Fair <br />)<Poor <br />❑ Inadequate <br />This report must be <br />kept on the <br />premises <br />with system location and pumping records. <br />WHITE COPY <br />/ Insl3ector's <br />File <br />GOLD COPY / Homeowner <br />