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ON-SITE SEWAGE TREATMENT <br />INSPECTION REPORT <br />On the North Shore of <br />Lake 4finnetonka <br />CITY POST Of ')X 66 <br />OF 1335 S. Bri_ . .J. <br />O . O O Crystal Bay, MN 55323 <br />473-7357 <br />OWNER G 46'7j /`CYZ CZ:� ADDRESS l q Z s— rLeili-no `1 <br />PHONE _ PERMIT NO'S. DATES _2 -Z-V <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 />❑ Meets or exceeds current city standards in all respects relating to design, construction, and location. Appears <br />to be operating proper'y. <br />Does not meet current city standards in some respects relating to design, construction, or location. Appears <br />42 to be operating properly. <br />❑ Uoes not meet current city standards in many respects relating to design, construction, or location. Appears <br />to be operating adequately. <br />❑ Does not meet current city standards of design, construction or location, is being overused, or is failing to <br />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 />Please 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 contractor must obtain a permit <br />before work is started. <br />WORK REQUIRED: <br />ElSeptic tanks must be pumped within 48 hours. <br />FDrainfield must be repaired or replaced within 90 days. <br />F1Inspection riser (4" diam. pipe) must be installed in each tank. <br />El Tank inspection indicates maintenance pumpout is needed as soon as possible. City ordinance requires that <br />tanks be pumped out every three years. <br />SITE CHARACTERISTICS: <br />r_imaing Site Factors <br />❑ Slope <br />Soil <br />❑High water table <br />❑ Lot size <br />Lake, wetland, or stream <br />❑Drainage <br />COMMENTS <br />Potential for System Failure <br />(depends on soil types, water <br />table, and system condition) <br />❑ Low <br />Medium <br />❑ High <br />❑ System is causing visible <br />surface discharge. <br />�-,?7- <br />Date of Inspection Septic System Inspec r' <br />This report must be kept on the premises with system location and pumping records. <br />WHITE COPY / Inspector's File GOLD COPY / Homeowner <br />Site Capabilities for <br />Future Expansion <br />❑ Adequate <br />9 Fair <br />❑ Poor <br />❑ Inadequate <br />