Laserfiche WebLink
N1ay 27 14 12:12p Joseph Olson 763-498-8290 p.3 <br /> Property address: 2660 Fox Street,_Orono. MN Inspector initials/Qate: J.0.4l12/14 <br /> 1. ImpaCt 011 Pub11C HeBlth—Compliance component#1 of 5 <br /> Compliance criteria: Verification rnethod(s): <br /> System discharge sewage to the ❑Yes � No � Searched for surFace outlet <br /> �round surface. � Searched for seeping in yard/backup in home <br /> Sysiem discharge sewage to drain tile ❑Yes � No � �cessive ponding in soi!systemlD-boxes <br /> or surface waters_ ❑ Nomeowner testimony(See Camments�Explanation) <br /> S stem cause sewa e backu into ❑ '81ack soil"above soil dispersal system <br /> y g p' ' ❑Yes I,� No <br /> dwelling or estabfishment. ❑ System requires"emergency'purnping <br /> Any"yes"answer above indicates the sysiem is C Performed dye test <br /> ❑ Unable io verify (See Comments/Fxplanation) <br /> an lmminent Threat to Pu6/ic Healih and Safety. ❑ Other methods not listed (See Comments✓�xplanation) <br /> Commenis/Expla nation: <br /> 2. Tditk Integrity—Compliance component#2 af 5 <br /> Compliance criteria: Verification method{s): <br /> _ _--�— <br /> System consists of a seepage pit, � ❑Yes � No � Probed tank(s)bottom <br /> cesspool,drytiveil,or leaching pit. � <br /> � �f Exarnined construction records <br /> Seepage pits meetirrg 7CSG.2550 may be ' ❑ Exarnined Tank Integrity Form(Attach) <br /> compliant if allowed in loca!ordinance_ <br /> --� — —��-� ❑ Observed liquid level below operating depth <br /> Sewage tank(s) leak below their , ❑Yes � No <br /> designed operating depth_ 0 Examined empry(pumped) tanks(s) <br /> If yes, which sewage tank(s) leaks: ! � ❑ Probed outside tank(s)for"b�ack soil" <br /> Any"yes"answer above indicates the O Unable to veriy!See Commenfs/Explanation) <br /> system is Failing to Protect Graundwater. ❑Other methods r�ot listed(See CommentsiExplanation) <br /> CommentslExpianation: <br /> 3. Othe�'Compliance Conditions—Compliance component#3 of 5 <br /> a. Maintenance hole covers are damaged,cracked,unsecured, or appear to structurally unsound_ ❑Yes* �nlo ❑ Unknown <br /> b. Other issues(e�ectncai nazards,et�.)to immediately and adversely impact public health or safety. ❑Yes" �No ❑unknow� <br /> "System is an imminent fhr�at to public healfh andsafeiy <br /> E�lain: <br /> c. Syslem is non-protective of ground water for other conditions as determined by inspecfor ❑Yes' �No <br /> *Systern is failing to protectgroundwater <br /> Expl2in: <br /> www.pca.state_mn.us • 65�-296-6300 • 800-b57-3864 • TTY 65�-282-5332 or 800•657-3864 • Available in alternative formats <br /> wq-wwtsts4-37 • ilZ4/iz Poqe 2 0�3 <br />