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Property Address: 1980 6" Ave North Orono MN <br />Business Name: Chips Septic Services <br />1. Impact on public health — Compliance component #1 of 5 <br />Date: 8/7/2025 <br />Compliance criteria: Attached supporting documentation: <br />System discharges sewage to the ® Yes ❑ No ❑ Other: <br />ground surface <br />❑ Not applicable <br />System discharges sewage to drain ❑ Yes' ® No <br />the or surface waters. <br />System causes sewage backup into ❑ Yes' ® No <br />dwelling or establishment. <br />Any "yes" answer above indicatos the system is an <br />inrminertt zt?r2at Fa /au lic peaitr and safe8y. <br />Describe verification methods and results: <br />Visual. Ran pump to determine hydrolic loading of system. <br />2. Tank integrity — Compliance component #2 of 5 <br />Compliance criteria: <br />System consists of a seepage pit, ;❑ Yes ® No <br />cesspool, drywell, leaching pit, <br />or other pit? <br />Sewage tank(s) leak below their ❑ Yes' ® No <br />designed operating depth? <br />If yes, which sewage tank(s) leaks: <br />Any eyes" answer above indicates the systern <br />is railing to protect groundwater. <br />Describe verification methods and results: <br />Attached supporting documentation: <br />® Empty tank(s) viewed by inspector <br />Name of maintenance business: Sewer Services <br />License number of maintenance business: 2502 <br />Date of maintenance: 8/7/2025 <br />❑ Existing tank integrity assessment (Attach) <br />Date of maintenance <br />(mm/dd/yyyy): (must be within three years) <br />(See foram instructions to ensure assessment complies with <br />Minn. R. 7082.0700 subp. 4 8 (9)) <br />❑ Tank is Noncompliant (pumping not necessary - explain below) <br />❑ Other: <br />Tanks were pumped and camera inspected at the time of inspection. The (2) 1000 gallon septic tanks were camera <br />inspected and found to have cracks and sidewall deterioration. The septic tanks are orginal when the house was built as the <br />pump tank was installed in 2000 when the system was updated. The two Septic Tanks will need to be replaced. City permit <br />will be required. Pump tanks every 3 years <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 Page 2 of 4 <br />