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MMINNESOTA POLLUTION Compliance inspection report form <br />CONTROL AGENCY f`' f'' <br />520 Lafayette Road North Existing Subsurface Sewage Treatment System (SSTS) <br />St. Paul, MN 55155-4194 Doc Type. Compliance and Enforcement <br />Instructions: Inspector must submit completed form to Local Governmental Unit (LGU) and system owner within 15 days of <br />final determination of compliance or noncompliance. Instructions for filling out this form are located on the Minnesota Pollution <br />Control Agency (MPCA) website at https://www.pca.state.mn.us/sites/default/files/wq-wwists4-31p.pddf. <br />Property information Local trackino number <br />Parcel ID# or Sec/Twp/Range: 2611823410013 Reason for Inspection Sale of property <br />Local regulatory authority info: City of Orono - 612-249-4600 <br />Property address: 1150 Mndmere Road, Orono 55391 <br />Owner/representative: Eric Dewees _ Owner's phone: 612-965-4034 <br />Brief system description: (2) 1500 Gallon Pre -cast Septic tanks (1) 1250 Gallon Pre -cast Pump tank, with a 10 x 75 foot rockbed with <br />18 inches of sand under rockbed. <br />System status <br />System status on date (mm/dd/yyyy): 7/23/2025 <br />® Compliant — Certificate of compliance' <br />(Valid for 3 years from report date unless evidence of an <br />imminent threat to public health or safety requiring removal and <br />abatement under section 145A.04, subdivision 8 is discovered or <br />a shorter time frame exists in Local Ordinance.) <br />"Note: Compliance indicates conformance with Minn. <br />R. 7080.1500 as of system status date above and does not <br />guarantee future performance. <br />❑ Noncompliant — Notice of noncompliance <br />Systems failing to protect ground water must be upgraded, replaced, or <br />use discontinued within the time required by local ordinance. <br />An imminent threat to public health and safety (ITPHS) must be <br />upgraded, replaced. or its use discontinued within ten months of receipt <br />of this notice or within a shorter period if required by local ordinance or <br />under section 145A.04 subdivision 8. <br />Reason(s) for noncompliance (check all applicable) <br />❑ Impact on public health (Compliance component #1) — Imminent threat to public health and safety <br />❑ Tank integrity (Compliance component #2) — Failing to protect groundwater <br />❑ Other Compliance Conditions (Compliance component #3) — Imminent threat to public health and safety <br />❑ Other Compliance Conditions (Compliance component #3) — Failing to protect groundwater <br />❑ System not abandoned according to Minn. R. 7080.2500 (Compliance component #3) — Failing to protect groundwater <br />❑ Soil separation (Compliance component #5) — Failing to protect groundwater <br />❑ Operating permit/monitoring plan requirements (Compliance component #4) — Noncompliant - local ordinance applies <br />Comments or recommendations <br />Ran pump to determine hydrolic loading of the septic drain field (mound). Septic tanks were pumped and inspected and found <br />that the baffle on the firstt tank was off. Replaced baffle and the tanks meet compliance. FILTER IN OUTLET OF 2ND TANK. <br />THIS MUST BE PULLED AND CLEANDED 2X YEAR. Pump tanks every 3 years <br />Certification <br />I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of <br />future system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, <br />inadequate maintenance. or future water usage. <br />By typing my name below; I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be <br />used for the purpose of processing this form. <br />Business name: Chip's Septic Se s Certification number: 4761 <br />Inspector signature: - License number: 2064 <br />(This document has en ronically signed) Phone: 952-200-3176 <br />Necessary or locally required supporting documentation (must be attached) <br />® Soil observation logs ❑ System/As-Built ❑ Locally required forms ❑ Tank Integrity Assessment ❑ Operating Permit <br />❑ Other information (list): <br />https://www.pca,state.mn.us • 651-296-6300 800-657-3864 Use your preferred relay service Available in alternative formats <br />wq-wwists4-31b • 412812021 <br />Page 1 of 4 <br />