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On the North Shore of Lake Minnetonka ON-SITE SEWAGE TREATMENT INSPECTION REPORT � POST OFFICE BOX 66 1335 S. Brown Rd. � � � Crystal Bay, MN 55323 473-7357 OWNER ��J �� ADDRESS �� rC11� �� `S' PERMIT NO.'S. ` DATES � CONTRACTORS ` City Ordinance No.210 requires that each on-site sewege treatment system in Orono be inspected on a regular basis.The on-site sewage treatment system at the above address has been inspected and appears to fall into the cetegory checked betow. IThis is � an existing system ❑ new construction) � � Meets or exoeeds current City standards in all respects relating to design,construction,and location.Appears to be operating properly. � 2 Does not meet all current City standards for new conatruction (1978 Code) but in most respects appears to be designed, located, and conatructed generally in accordance with previous codea.System appears to be functioning properiy;no major upgrading of the system is required at this time. �3 Does not meet current City standards in many respects relating to design,construction,or location.Appears to be operating adequately at this time, but has a relatively high potential for future problems. No major upgrading of system is required at this time. � 4 System may or may not meet current City standards for design,construction ot location, but is failing to properly treat and dispose of the current input,and is endangering a water supply,or is a source of pollution to surface or groundwaters,or is creating a safety hazard,or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/ replacement procedures. If drainfield replacement is necessary,soil testing will usually be required,and a design and site plan must be submitted for review.Your contractor must obtain a permit before work is started. SYSTEM CONDITION ( m Checked items may require your action) Tank inspection indicates: ❑ Inspection pipe is located directly over tank beffle.(Does not ❑ Pumpout not needed at this time, give accurate measurement of solids accumulation.) If tanks ❑ Solids accumulation in tanks indicates they ahould be pump� have not been pumped out within the last three years,they ed out this year to help prevent future problems. should be pumped out now. ❑ Solids accumulatio� in tanks is at a critical level. Tanks Drainfield inspection indicates: :hould be pumped out as soon as possible. ❑ Drainfield is dry,no surfacing evident. ❑ System is discharging to surface. Tanks must be pumped ❑ Some evidence of surfacing,not criticat yet. �l within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated Sy� I�l Inspection risers miuing—tanks could not be inspected, effluent to the surface. This condition may require replace- Inspection risen (4"dia. pipe)must be instaNed in each tank ment or additions to drainfield. Contact the City Inspector at next pumpout. If tanks have not been pumped out within immediately.Repaira must be completed within 90 days. the last three yean,they should be pumped out now. ,� Drainfield extent and co�dition unknown. SITE CHARACTERISTICS: Limiting Site Factora Potential for System Failure Site Capabilities for ❑ Slope (dePends on soil types,water Future Expansion ❑ Soil table,and system conditionl ❑Adequate ❑ High water table ❑ Low ❑ Fair ❑ Lot size �Medium �Poor �Lake,wetland,or stream ❑ High ❑ Inadequate O Drainage ❑System is causing visible surfa discharge. COMMENTS: � �� / 7 �.�.�fliln or�,e �Ba✓' ��1'n�� ci'tv sD sam orre. c ra r ,6 2 �Q`"//�� Date of Inspection Septic System Inspector Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that this report does not guarantee or certify that an existi�g system will continue to function properly,but is merely an opinion of the adequacy of the system under current conditions based on the available information. This report must be kept on the premises with system location and pumping records. WHITE COPY/Inspector's File GOLD COPY/Homeowner