Laserfiche WebLink
Property address: 4220 Chippewa La Orono,MN 55359 Inspedor initials/Date:� 12/16/2015 <br /> (n►m/dd/YYYY) <br /> 1. Impact on Public Health—Compliance component#1 of 5 <br /> Com liance crFteria: Verification method(sj: <br /> System discharges sewage to the ❑Yes � No ❑Searched for surfaoe outlet <br /> ground surface. �Searched for seeping in yard/badcup in home <br /> System discharges sevwage to drain ❑Yes �No ❑ Excessive ponding in soil system/D-boxes <br /> tile or surface waters. ❑Homeowner testimony(See Comments/Explanation) <br /> System causes sewage badcup into �Yes ❑No �•Bladc soil'above soil dispersal system <br /> dwelling or establishment. y � ���„P p� <br /> ❑S stem r uires" um i <br /> Any"yes"answer above indicates the ❑ P���t� <br /> system is an imminent thr+eat to public ❑ unab�e to v <br /> erifY(See ConMnents/Explenadon) <br /> healdh and saf�ety. ❑ pther methods not�isted(see cann►enrs/Explanati�or►) <br /> Commerrts/Explanation: <br /> 2. Tdnk Inte�rity—Compliance component#2 of 5 <br /> Com liance criteria: Verification method(s�: <br /> System consists of a seepage pit, �Yes ❑No �Probed tank(s)b�tom <br /> cesspool,drywell,or leaching pit. <br /> ❑Examined oonstruction records <br /> Seepag�e pits meedng 7080.2550 may be ❑Examined Tank I�egrity Form(Attech) <br /> compliant i/albw�ed in local adinance. <br /> Sewage tank(s)leak below their �Yes ❑ No ��bserved liquid level below operating depth <br /> designed operating depth. ❑ �mined empty(pumped)tanks(s) <br /> If yes,which sewage tank(s)leaks: both tanks � P�abed outside tank(s)for'black soil' <br /> Any "yes"answer above indicates ti►e ❑ Unable to verify(See Comments/Explenebon) <br /> system is failing to protect groundwater. ����s not iisted�s�corr��»er►r��asa,� <br /> Commen�s/Explanation: <br /> 3. Other Compliance Conditions—Compliance oomponent#3 of 5 <br /> a. tNairrtenanoe r,ae oovers are damaged,c.�adced,unse«,r�ed,or appear to be smxx�urally unsound. ❑Yes• �No ❑unknown <br /> b. Other�ssues(e�ecbnical h�ard�et�.)to immediately�d ad�ersely imped pubic health or satety. ❑Yes' �No ❑Urrcnown <br /> '3ystem is an imminerrt threat to puWic haaHh and saf�ety. <br /> Explain: <br /> c. System is norrprotective of ground waber for ofh���s as detemrned by inspedar. ❑Yes' �No <br /> *Systan is failing to puotect groundwatar. <br /> Explain: <br /> www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTIf 651-282-5332 or 800-657-3864 • Available in altemative formats <br /> ......•--�...�. �.� _ ��.�,. PaQe 2 of 3 <br />