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Apr 29 14 10:42a Joseph Olson 763-498-8290 p.3 <br /> Property address: 3535 Christine Drive,Orono,MN Inspector initiafslDate: J. O.4l21114 <br /> 1. Impact on Public Health—Campliance eomponent#1 of 5 <br /> Compliance criteria: Verification me#hod(s): <br /> System discharge sewage io the I �Yes ❑ No � Searched for surFace outlet <br /> ground surface._ � Searched for seeping in yardlbackup in home <br /> System discharge sewage to drain tile ❑Yes �No n �cessive ponding ir�soil system/0-boxes <br /> or st�ffaCe walers. ❑ 1�omeowner testimony(See Commenis/��pJanatron) <br /> ❑ "Black soil"above sal dispersal system <br /> System cause sewage beckup into ❑Yes � No <br /> dwelfing ar estab3ishment. ❑ System req�ires"emergency° pumping <br /> ❑ Performed dye test <br /> Any"yes"ansrver above indicafes fhe system is ❑ Unable to ver' <br /> an lmminent Threat to Public Healfh and Safety. '�Y(S��amments�xpianatron) <br /> _� _ � _ ❑ Other methods not listed{See CommentsiExplanation) <br /> Comme ntslExp la nafian: <br /> When the purnp is running septic efFlueni comes out of the mound system. <br /> 2. Tatlk IlltePr'ity—Compliance component#2 of 5 <br /> Compliance criteria: Verification method�s): <br /> System consisls of a seepage pit, ❑Yes ❑ No ❑ �'robed tank(s)bottom <br /> cesspool,drywell,or leaching pit. <br /> ❑ Examined oonstr�ction records <br /> 5eepage pits meeting 7080.2550 maybe I ❑ Examined Tank Integrity Form(Attach) <br /> cornpfiant if allowe�rn local ort�inance. ' <br /> -- — - ❑ dbserved liquid leael below operating depth <br /> Sewage tank(s)leak below their I ❑Yes ❑ No <br /> designed operating depth_ ❑ Examined empty(pumped)tanks(s) <br /> If yes,which sewage tank(s}leaks: ❑ Probed auiside iank(s�for"black soil" <br /> Any "yes"answer above indicates the � �nable to venfy(see Comments��icplanation) <br /> sysfem is Failing to Profect Groundwater. �01her methods nat listed (See Comments�Explanation) <br /> Comments/Explanation: <br /> 3. Other Compliance Condifiions—Compliance component#t3 of 5 <br /> a. Maintenanr,e hole covers are darnaged,craciced,unsecured,or appear to structurally unsound. ❑Yes* ❑No p Unknown <br /> b. qther issues{elechicafhazarols,erc_)to irnmediately and adversely impact pubEic healfh or safety. ❑Yes' G No O Unknown <br /> "System is an immirtent threai to pubfic heal�and safety <br /> Explain: <br /> c. System is non-protective of ground water for other conditions as determined by inspector ❑Yes' ❑No <br /> "System is failrng to protectgroundwater <br /> Explain: <br /> www.pcastate.mn.us • 659-Z96-6300 • 800-657-3B64 • TTY 651-282-5332 or 800-657-3864 • Available in alternative iormaCs <br /> wq-wwists4-31 • lfZ4/1Z Page 2 of 3 <br />