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03/04/2015 13:58 9528733112 PAGE 01/a4 <br /> �,� Minnesota Pviluti�n �prp �ldi'1G� �I"1S ection Farm <br /> �-=- Contra! Agency p p <br /> 524 Lafayette Road Warzi, Existing Subsur#�o� Sewage Treatment Sy�t�ms (sST3� <br /> St.Pavl,MN 55155-d194 Doc 7Ype:Comp!lanca and EnforCement <br /> InSp�GtYon �esults b25Ad on Minnesota PolluNon Contro)Agancy(MPCA) For local tracking purposes: <br /> requirements and attached forms—additional local requlremenis may also apply. (�ii-.;� 0 4 201 a <br /> Submit nompleted forrn to LoC�I Unit of Governmerit(LUG)and ayst�m owner <br /> withln 15 days �t4 � ^� ����V' <br /> System 5tatus <br /> 3yst�m status on date(mm/ddFyyyy): 3/3/2015 <br /> �( Compliant— Certificate of Complfance � Noncompliant — Notice of Na�lcomp{�ance <br /> (Valia'for 3 years from report date, unJass shorter time (See Upgrade Requirements on page 3.) <br /> frame outNnecY rn Loca!drdinance.) <br /> R�asan(s)for nonaompliance{check all appllca8lel <br /> ❑ImpaCt on PubliC Health (Gompliance Componen€�'l)—Imminent threat to pub!!c fiealth and saf�fy <br /> ❑ Other ComplipnCA Conditions(Compliarrce Compon9nt#3)�Imminent fhreat to public hgalfh and safety <br /> ❑7ank Integrit�+(Compliance Gomponent�+2)—Failing to profsct groundwar�r <br /> ❑bther CompHance Conditions(Compliance Component�3)—F�fling to pratect groundwafa� <br /> �]Sc�ll Separatian (Complianc�Componant#4)—�ai�ing fr protect groundwater <br /> � Operating permit/monitoring plan requirements(Cor»pliance Componenl�5)—Noncompliant <br /> Property Information parcel ID#nr Sec/Twp/Range: <br /> Property address: 2515 Count Side Drive-Orvno F�eason for inspection: 5ale <br /> Prpparty owner: Chris Kahler Owner's phone; 952-928-9559 ___ <br /> or <br /> Owner's representatl�e: Representative phone: <br /> Local regufatory authority „CitY _ Regulatory authprity phone: <br /> Brief system description: 1250&1000 gallon septic tanks& 1250 gal pump tank 8�_Mound System <br /> Cnmments or recommendatlons: <br /> System does npt ha�e an High Level Ala�m fvr khe pump tank, Needs to have one instalEed to be code compliant <br /> Cert9flcation <br /> I hereby Cerliiy�hat aJl the necessary informatron has been gafhered to defermine the Compliance status of this system. No <br /> deferminatian of fuf�re system pertormance has been r,or can be made dua to unknown condltlons dunng systam constructron, <br /> possible abus�ot�he system, inadequate mainrenance, or future water usage. <br /> Inspector name: Josh Swedlund Certificatian numb�r G1659 <br /> Business nam2: Swr�dlun Ic S ice License number: 2502 <br /> mspector signature� Phone number: 852-873-3292 ____ <br /> Necessary or� Ldc lly Required Attachments <br /> �Sail boring logs �System/As-built drawing �Forms p�r local ordinance <br /> [�Other informatron (list): <br /> www.pCd.StdCe.mn.us • 657-296-8300 • 800-657-3864 . TTY 651-Z82-5332 or 800•b57-3864 • Avdildble in attemaClve formats <br /> wq•wwists4-31 • 3/16J 12 Page 7 of 3 <br />