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Ju111 1212:05p Joseph Olson 763-498-8290 p.6 <br /> P�aperty address: 1749 N. Farm Rd.. _y Jnspector initiaislData 7/8l� <br /> 1. impact on Pubti'� Health—Compliance component#1 of 5 <br /> _Compliance cnteria: Ver�cation method(s�: <br /> System discharge se�wege to the ' ❑ Yes ❑ Vo ❑ Searched for surface ou�let <br /> ground surfac�. ___ __ � __ ❑ Searched for seeping in yard/isackvp in home <br /> System discharge sewage tc drairt fii� ': �Yes �No � �0���'��onding in soil system/D-baxes <br /> or surface waters. � ❑ hfomeo�mer testimony(See cwnmentsExplanadon) <br /> ❑ "Black soil"above soil dispersal system <br /> System cause sewage backu�in#o i ❑Yes ❑No ❑ System requires"emergency"pumping <br /> dwelling or establishinent <br /> My"yes"ans�er above indreates tl�e system fs � pQ�O�d dye test <br /> an lmrnir�ent Thr+eat tn Public Healfh and Safety. � Unable to verify(See Commem�tplanatian) <br /> , _ , ❑ Othe�methods nait listed(See Comments�cpfar+ahon) <br /> Comments/Explanation: <br /> 2. Tank Integrity—Campliance componem#2 of 5 <br /> Cocnpliance criteria: � __ Ver�cation rnethod{s): <br /> System consists ofa seepage pit, � ❑ Yes � No ❑ Probed tank(s)bottom <br /> cesspool, drywefE,or leaching pit ; ❑ Examined constructio�recards <br /> Seepage pifsmeeb'ng T08D.2550 may 6s � ❑ Examined Tank Integ�ity Form(Attacl,) <br /> campr'ant 1f allowed in local orclinance. <br /> — ' � ❑ Observed liquid level below operating depth <br /> Sewage tank(s){eak below tiieir : ❑Yes �No � Examined empty{pumped)tanks(s) <br /> �egigned operadng depth. <br /> If yes,which sewage tankfs)leaks: ; ❑ Probed outside�ank(s)for`black s�il" <br /> AII�/ "yes'°answer abave indicai�es tha � Unableto verify{See Gommanrs/Ezplanatian) <br /> syst+cirn is Fa�ling to Protect Groundwat{eer. � aher metnods noc r�d �s�c�rme►�r�,cp�„�on� <br /> CommentslEuplanatior�: <br /> Or�7l9I�2, F_Imer J. Peterson Co. pumpad fhe sept�c tanks. {Vo cracks or water leaks at that 1ime, High water alarm was <br /> tested and vrorks fine. �tiere is se�ere corrosion ati6nre tFie liquld level of all three tank covers and the concrete riser en fift <br /> station, <br /> 3. Other Compliance Condit�ons—Compiiance compone��3 oF 5 <br /> a. I'Jlaintenance ho�e covers ar�damaged,cxadced, unsecured,or appear to sstruc�uurafly Lr�sound. p Yes" �No p urdmown <br /> b. Other issues(elechic�hazards,etc.)to immediately and adversely impact public healtl�vr safa;y. �]Yes' Q No ❑Unknown <br /> ''�ystem is an immFneni thr�eat to pualic hea/th and safery <br /> Explain: <br /> c. System is non-pratecbve of ground water for ott�er conditions as deiermined by inspector O Yes• p No <br /> '�yst+em is fa�7irry to protertgroundwai+er <br /> Explairt: <br /> www.pcestate.mn.us • 651-296-6300 • 80Q-657-3864 • TTY 651-282-5332 or$00-bi7-3864 • Available in alt�native'ortnats <br /> wq-wwisCs+3f • f/24/f2 AaqeZ of 3 <br />