Laserfiche WebLink
. � <br /> Minnesota Poi�ution Compliance Inspection Form <br /> �� Control Agency <br /> 520 Lafayette Road North Existing Subsurface Sewage Treatment Systems {SSTS) <br /> St.Pauf,MN 55155-4194 Doc Type:Compliance and Enforcement <br /> Inspecti��n results based on Minnesota Pollution Control Agency(MPCA) For local tracking purposes: �� <br /> requirements and attached forms—additional local requirements may also apply. _ <br /> Submit completed form to Local Unit of Government(LUG)and system owner <br /> within 15 days �� <br /> System Status <br /> System status on date(mm/dd/yyyy): 4/17/2017 <br /> � Coimpliant— Certificate of Compliance ❑ Noncompliant— Notice of Noncornpliance <br /> (Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3.) <br /> frame outlined in Loca!Ordinance.) <br /> Reason(s)for noncompliance (check al!applicab/e) <br /> [] Impact on Public Health (Compliance Component#1)—lmminent threat to public health and safefy <br /> [�Other Compliance Conditions(Compliance Component#3)—lmminent threat to public health and safety <br /> []Tank Integrity(Compliance Component#2)—Failrng to protect groundwater <br /> ❑ Other Compliance Conditions(Compliance Component#3)—Failing to prr�tect groundwater <br /> ❑ Soil Separation (Compliance Component#4)—Failing to protect groundwafer <br /> ❑ Operating permiUmonitoring plan requirements(Compliance Component#5)—Noncompliant <br /> Property Information Parcel ID#or SeclTwplRange: <br /> Property address: 465 Hunter Pass, Orono _ Reason for inspection: Sale <br /> Property owner: Jennifer Foster Owner's phone: 952-334-2757 <br /> or - <br /> Owner's rEpresentative: Representative phone: <br /> Local regulafory authority: City ,_ Regulatory authority phone: <br /> Brief system description: 1300& 1000 Septic with a 1300 gal pump tank 5 bdrm maund system <br /> Comment�or recommendations: <br /> Electric cords for pump and floats is not in electrical conduit,they are just buried in dirt. Tap section of riser should be replaced with <br /> plastic and a 2.5"electrical conduit installed <br /> Certific�tion <br /> J hereby certrfy that all the necessary information has been gathered to determine the compliance status of this system. No <br /> deterrnination of future system performance has been nor can be made due to unknown conditions during system construction, <br /> possible abuse of the system, inadequate maintenance, or fufure water usage. <br /> Inspector name: Josh Swediund Certification number: C1659 <br /> Business name: Sewer S ' es I c� �� License number: 2502 � <br /> Inspector signature: _ Phone number: 952-873-3292 <br /> Necessary or L cally Required Attachmenfis <br /> � Soil boring logs � System/As-built drawing � Forms per local ordinance <br /> ❑ Other information (list): <br /> www.pca.sta.te.mn.us • 651-296-6300 • 800-657-3864 • TTY 651•282-5332 or 800-657•3864 • Available in alternative formats <br /> wq-wwfsts4-31 • 3/ib/1Z <br />