Laserfiche WebLink
Sep 02 09 08:13p Joaeph Oleon 783r.�9�3294 p.3 <br /> � <br /> � Paroel number: System statu�: �Gompl'iarrt ❑Nonoompliant <br /> `�.W_.,�. (a5 detem►iried Ay this�om►) <br /> liydraulic Pe�fonr�ance and 4ther Comptiance <br /> Compi�ance Issue #1 of 4 <br /> Da�te of observafion: 9�01/D9 __ Reason for ob9ervalion: Prqperly Transfer <br /> This torm expires upon ne�ir�.p�ction or in thre�yeers,wli�chever occiirs fus�: 9I01l12 <br /> Compl'�ance questionsJc�iteria: (Required) Ve�cation Method': {Optional) <br /> _�_Chock U�e app�pdate Dox (Chock the appropnal+e boic) <br /> Does the systam discharge sew�ge to the ❑Yes � f�lo � ���r sur(ace outlet <br /> _,ground su�faoe? - [� Perfom7ed hydrauG�test <br /> Ooes the system discharge sewage to draa� ❑Yes � No <br /> tile or surfaoe wat�ers? --,----..., ��.� I� Searched for seeping in yard <br /> Does the system puse sewage backup ❑Yea �No � Chedced tor badcup in home <br /> ir►to ctWelFn9 w 0atablishm�cd? [� Excessive ponding in sail system/0-boXes <br /> Do other silua6ons�cist Ihat have the ❑ Yes I�I No � Homeown�r testimony <br /> potsrn;a�to arar�ed�t�y ana ad+►erse�y <br /> a�nnpaod ot th�ten publiC healih or sefe�y � Examir�ed for sur+ging in tank <br /> �{aleGcicalyunsafe covers, e1cJ? <br /> Any'�es'aasw�r�ndlca[r•s LFr�et the sys�evn 1s an la�minent � �Black so�"abov�soil dispersal sysiern <br /> Lhroet to publk leaal�analsal�Siy. ❑ System requires'emer'O��Y P�mPin9 <br /> --.__—.........._....._....,..-. ❑ Pe�formed dye test <br /> Does the system pose a threat to ground i ❑Yes � No � aher: <br /> w�teriorsny oond�0ons deemed non- _._�.....�...._,.._ .,...,r..,__� <br /> _pr�o4acii+re as d�t�Mad b�.1�e!nspectcr:' — ,^, .,,.._...�_ <br /> "Ye�p fiidl�oAsi d►e sys�n ls faJlfng to prot�ect <br /> grovnd waEer.!I►'"y�e�s".descti�be the coRdlEion noGeQ .._...._ <br /> 'No stande►d pr+�t000�l exests. 7his/est is not exheustive. <br /> --._..�._._�_..,__.��.._.. in�7uentiel ader,ncrqbes it iMliced�wh�ch <br /> caribin�etior+s ar�necessery-to rrieke this del�mmune�h'on. <br /> Certifi�ation � ` <br /> This torm is to be campleted and attadied to the Summary Fortri of the Minnesota Pollution Cor�oZ Agency's(MPCA)Compliance <br /> Ir�spec�ion Farn Tcr Existi�g Subsurtaoe Sewage Trealmemt Systems.Obseivations.interpretations,and condusions must be <br /> oompleled by an inspecto�.Completed!�m must be submitted�o the lopl unit of govemment within 15 days. <br /> Property owner name(s): Todd 8 Amy Hartmsn ,._ <br /> Property address: BO MYNeweod Road.Orono, MN 5539'I <br /> Property owners address(N diiferontk <br /> Couniy; Nennapin Phone: 612-518,2291 _.._,,, __ <br /> l he�by ceiEily lhet f pe�afly mude the observation� ir�erpretaban.�and canNusians►eporl�d on th�s�oRn ana that they are <br /> con�ect <br /> Name: Joseph J.Olson Cer�ific�ation number: 1256 <br /> Busi►�ess ticanse name and number: Rusty Olson's soii and pe�ulation Lesfing Lic#81�� , or <br /> Name of Ioc�l un' govemm .�. City ofi Orono <br /> Sig�eture: _.._.__.. .....,...,. Dale: 9101/09 <br /> wq•wwis#s4•3� Comqp/�ance Itypecrfor�Form jor Existing SSTS <br /> 414/O�B <br />