HomeMy WebLinkAboutSeptic info �o�
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-�-����� CITY of ORONO
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� �'�5 Street Address: Mailing Address:
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9$EggO 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323•0066
Owner: �/� .���� Address: 2160 Shavlin Dr.
Permit #'s: 3709 Dates: 7/17/73 Contractors: Ouversoa Exc.
(This is [x] an existing system [ ] new construction) .
SYSTEM COMPLIANCE (1-3) : 3
1 Code System: Me�ts or exceeds current City standards in all respects relating to design,
construction, and location. Appears to be operating properly.
2 Compliant System: Does not meet all current City standards for new construction, but in
most respects appears to be designed, located, and constructed in accordance with previous
codes and is functioning properly.
� Non-Compliant Sy�tem: System may or may not meet current City standards for design,
construction, or location, but is failing to properly treat and dispose of the current
input; and any system with less than three feet of vertical separation between the bottom
of the drainfield and the saturated soil level.
(The saturated soil level [x ] has or [ ] has not been identified at this time. If the
saturated soil level has not been identified, this classification is subject to revision.)
K CONDITION (5-9) : 5
Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year.
7 System is discharging to the surface. Tanks must be pumped out within 48 hours.
8 Inspection risers missing-tanks could not be inspected. If tanks have not been pumped out
within three years, they should be pumped out and risers installed now.
9 Inspection pipe is located over tank baffle-can not measure solids accumulation. If tanks
have not been pumped out within three years, they should be pumped out now.
(DuriaQ the last septic tank Maintenance Putqpout tha tanks [ ] were or [�) were aot confirmad
to be waterti�ht by the licensad pux�inQ contractor. If the tanks were not confirmed to be
watartiQht, this clas�i£ication is subject to revision.)
INFIELD CONDITION 11-14) : 11
Drainfield is dry, no surfacing evident.
12 Some evidence of surfacing, not critical yet. Repair is not required at this time.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface.
Contact the City Inspector immediately. Repair must be completed within 90 days.
14 Drainfield extent and condition unknown.
POTENTIAL FOR SYSTEM �AILURE: (system age and condition, soils, etc.) : madium
COMMENTS: In order to confirm that your septic system meets Minnesota standards, soil borings
were performed to vezify a 3 foot separation between the drainfield and the seasonal water
table. The separation is 0 feet and the system is non-compliant. Repair or replacement of the
septic system is required by 12/31/2001.
_ �`j /
%t,�
Date of nspection S ic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a
transfer of property,', this report does not guarantee that an existing system will continue to
function properly, bu� indicates the operation of the system under current conditions.
Telephone (612) 473-7357 • FAX 473-0510
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I O
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CITY OF ORON O
M�micipal Offices
Post Office Box 66 !
Crystal Bay, MN 55323-0 � i � ON—SITE SEWA(3E TREATl�NT
r�,� . ; � INSPECTION REPORT
'� i�~
� �9kEs8o4'
Owner• ��nl� l�fY�r Address•
Permit �'s:�Q�Dates: /��7� Contractors:�U(�d.��1'1
City ordinance number 100 equires that each on-site sewage treat nt system in Orono be inspected on a regular basis.
The on-site sewage treatme�t system at the above address has b�en inspected and appears to fall into the category
checked below. ;
(This is �, an1existing system [ ] new construction) �'
STSTEM CONFORMITT (1-3):
1 "CODE SYSTEM"-A sys em which meets all the location, desig�, and construction standards of the current City
Codes, and whic ' is operating satisfactorily by treatin and disposing of the entire current sewage input
without dischar �ng any pollutants into ground or surfa e waters.
2 "CONFORMING SYSTEM' A system uhich does not meet all the, location, design, and construction standards ot the
current City C s, but was installed according to the code in effect at the time of instaltation, and which
is operating sa isfactorily by treating and disposing af the entire current sewage input without discharging
any pollutants i to ground or surface waters.
3 "NON-CONFORMING SY TEM�'-A prohibited system; a system lOcated within a designated 100-year floodplain; any
system which ma or may not meet all the location, design, and construction standards of the current City
Codes and which 'is failing for any reason; and any s stem ' less than f unsaturated soil or sa
between the dis ibution device end the limitin c aracterts �cs. �/r �'Q�
� (The limiting s � characteristic has or [ ] has not been identified a this . If the limiting soil
characteristic h s not been identi i , this classification may be subject to revision.)
TANK CONDITION C5-10): �
Tank inspection indicates:
5 Pumpout not needed at his time.
6 Solids accumulation in tanks indicates they should be punped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. 'fanks should be punped out as soon as possible.
8 System is discharging o the surface. Tanks must be punped out within 48 hours to eliminate surface dischar�e.
9 Inspection risers miss ng-tanks could not be inspected. lnspection risers (4" dia. pipe) must be installed in each
tank at next ut. If tanks have not been punped owt within the last three years, they should be punped
out now.
1 Inspection pipe is lo eted directly over tank baffle (does nmt give accurate measurement of solids accumulation).
1f tanks have no been punped out within the last three years, they should be punped out now.
i
DRAINFIELD CONDITION 11-14 :
D�nfield inspection indica es:
11} Drainfield is dry, no urfacing evident.
`f2 Some evidence of surfa ing, not critical yet.
13 Drainfield is saturat and visibly discharging untreated effluent to the surface. Contact the City Inspector
imnediately. Re irs must be completed within 90 days.
14 Drainfield extent and ondition unkno►m.
LIMITlNG SITE FACTORS slo setbacks etc. :
POTENTIAL FOR SYSTEM fAILURE�(decends on soils,water table.etc.): ' /����
�L/
COMMENT : � �
� �01'�
Date o nspection p c Sy em inspector
Note: In the event that thi inspection report is used to satisfy Rhe requirements for a mortgage or other transfer of
property, be advised that th�s report does not guarantee or certif�y that an existing system will continue to function
properlyi but is merely anlopim on of the adequacy of the systdm under current conditions based on the available
information. ,
This reportjmust be kept on the premises with the system locetion and punping records.
WH17�COPY/Inspectors File YELLOW COPY/Homeowner
�
CITY
OF ORON �O�
Municipal Offices O O
Post Office Box
Crystal Bay, MN 55323- 066 � � ON—SITE 3EWA(�E TREA'1'l�NT
� . � IN3PECTION RF,PORT
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9kEsxo�'�
Owner: L,r(X��I ���01�� Address:_�I� �x"d�iT'� i(Jr.
Permit �'s: Dates: ��7�/3 Contractors: /iC/i/�°Y� �C�
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treat nt system at the above address has been inspected and appears to fall into the category
checked below.
(This is�]- a existing system [ ] neu construction)
SYSTEM CONFORMITT C1-3):
1 "CODE SYSTEM"-A s tem which meets all the location, design, and construction standards of the current City
Codes, and whi h is operating satisfactorily by treating and disposing of the entire current sewage input
without discha ging any pollutants into ground or surface waters.
"CONFORMING SYSTE "-A system which does not meet all th,e location, design, and construction standards of the
current City C es, but was installed according to th¢ code in effect at the time of installation, and which
is operating s tisfactorily by treating and disposing'�,of the entire current sewage input without discharging
any pollutants into ground or surface watgrs.
3 "NON-CONFORMING S STEM'�-A prohibited system; a system Ilocated within a designated 100-year floodplain; any
system which y or may not meet all the location, design, and construction standards of the current City
Codes and whic is failing for any reason; and any.sy�stem with less than 3 feet of unsaturated soil or send
between the di tribution device and the limiting soil characteristics.
(The limiting oil characteristic [ ] has or �] has mot been identified at this time. If the limiting soil
characteristic has not been identified, this L�lassificetion may be subject to revision.)
TANK CONDITION C5-10): +�—
y-'t
T�k inspection indicates:,
Punpout not needed a this time.
6 Solids accunulation in tanks indicates they should be rxnped out this year to help prevent future problems.
7 Solids accunulation in tanks is at a critical level. 'fanks should be pumped out as soon as possible.
8 System is dischargin to the surface. Tanks must be punped out within 48 hours to eliminate surface dischar�e.
9 Inspection risers mi sing-tanks could not be inspected. Inspection risers (4�� dia. pipe> must be instelled in each
tank at next ut. lf tanks have not been punped out within the last three years, they should be punped
out now. '
10 Inspection pipe is lpcated directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have rrot been punped out within the last three years, they should be Fxmped out now.
DRAINFIELD CONDITION 11-1 :
Dr field inspection indi�ates:
Drainfield is dry, n surfacing evident.
�Some evidence of sur cing, rwt critical yet.
13 Drainfield is satur ted and visibly discharging untreated effluent to the surface. Contact the City inspector
immediately. I�epairs must be completed uithin 90 days�
14 Drainfield extent arxi condition unknown.
,
LIMITING SITE FACTORS slo setbacks etc. :
POTENTIAL FOR SYSTEM FAILUf�E (decends on soils,water table,etc.): j/yf,y�'�y..�
�rujri�
COMMENTS:
,
Date of Inspection ; eptic System Inspector
Note: In the event that t is inspection report is used to satisfy the requirements for a mortgage or other transfer of
property, be advised that his report does not guarantee or certlify that an existing system will continue to function
properly� but is merely op�nion of the adequacy of the sysltem under current conditions based on the available
information.
This repo t must be kept on the premises with the system locetion and pumping records.
WF�ITE COPY/Inspectors File YELLOW COPY/Homeowner
I
On the North Shore of
Lake Minnetonka
ON-SITE SEWAGE T EATMENT
INSPECTION R PORT � POST OFFICE BOX 66
1335 S. Brown Rd.
� � Crystal Bay, MN 55323
473-7357
OWNER �'� AD�RESS ���0 ��°y!'� �,!! �
PERMIT NO.'S. DATES 7��� CONTRACTORS LLJ�°�SOI'� �Xc.
City Ordinance No. 21 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The onsite sewage
treatment system at the above address has been inspected and appears to fall into the category checked below.
(This is ef ¢n existing system ❑ new conatruction)
� � Meets or exc�eds current City standards in all respects relating to design,construction,and locetion.Appears to be operating
properly. I
�2 Does not m�atl current City standards for new construction (1978 Code) but in most respects appears to be designed,
located, and nstructed generally in accordance with previqus codes.System appears to be functioning properly;no major
upgrading of e syster+n is required at this time.
� 3 Does not m�current City standards in many respects relating to design,construction,or location.Appears to be operating
adequately att this time,but has a relatively high potential fqr future problems. No major upgrading of system is required at
this time. �
� 4 System may r may not meet current City standards for design,construction or location, but is failing to properly treat and
dispose of th current input,and is endangering a water supply,or is a source of pollution to surface or groundwaters,or is
creating a saf ty hazard,or is otherwise creating a public nuieance.Plmase contact the City Inspector to discuss system repair/
repl�ement ocedures. If drainfield replacement is ne�ssany,soil testing will usually be required,and a design and site plan
must be su tted for review.Your contractor must obtain a pe�mit before work is started.
SYSTEM CONDITION (m C ked items may require your action)
Tank.inspection indicates: ❑ Inspection pipe is loceted directly over tank baffle.(Does not
�Pumpout not needed at his time, give accurate measurement of solids accumulation.) If tanks
❑ Solids aecumulation in nks indicates they should be pump- have not been pumped out within the last three years,they
ed out this year to help revent future problems. should be pumped out now.
❑ Soli� accumulation i tanks ia at a critical level. Tanks Drainfield inspection indicates:
should be pumped out soon as possible. '�Drainfield is dry,no surfacing evidenL
❑ System is diacharging o aurface. Tanks must be pumped ❑ Some evidence of surfacing,not critical yet.
within 48 hours to elimi ate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
❑ Inspection riaera missi —tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risera (4"di pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanNcs have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they'should be pumped out now. ❑ Drainfield extent and condition u�known.
SITE CHARACTERISTICS: '
Limiting Site Factors � Potential for System Failure Site Capabilities for
❑ Slope ' (depends on soil types,water Future Expansion
❑ Soil table,and system condition) ❑Adequate
❑ High water table � ❑ Low ❑ Fair
❑ Lot size �-Medium '��Poor
❑ Lake,wetland,or stream� ❑ High ❑ Inadequate
❑ Draina� ❑System is causing visible
� surface discharge.
COMMENTS:
I
I
3-/�,Z
Date of Inspection Septic System Inspector
Note: In the event that this ins ection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that
this report does not guarantee r certify that an existing system will continue to function properly,but is merely an opinion of the adequacy
of the system under current con itions based on the available information.
�
Th�s report must be kept on the premises with system location and pumping records.
WH E COPY/Inspector's File GOLD COPY/Homeowner
i
�I
;
On the North Share o f
'� Lake Minnetonka
�-SITE SEWAGE T EATMENT
INSPECTION RE,ORT � ' POST OFFICE BOX 66
� . � � 1335 S. Brown Rd.
Crystal Bay,MN 55323
473-7357
�WNER ' � ��� ADDIRESS ���,I�//[Ih ��!`
PERMIT NO.'S. �� DATES ����� -� CONTRACTORS �vl�✓�� �`�
City Ordinance No,21 requires that each on-site sewage treatment syqtem in O�ono be inspected on a regular basis.The on3ite sewage
treatment system at the above ress has been inspected and eppears to fall in�o the caCegory checked below.
(Tfiis is � existing system ❑ new construction) -
� � Meets or ex ds current City standards in all respects relatir�g to design,construction,and location.Appears to be operating
properly. •
I'C�'2 Does not me t all current City standards for new construcyion (197�$ Code) but in most respects appears to be designed,
J�,�• located, and Onstructed generally in accordance wiih previoys codes.�System appears to be functioning properly;no major
upgreding of t e system is required at this time.
� 3 Does not mee current City standards in many respects relating to de9ign,construction,or location.Appears to be operating
adequately at his time, but has a relatively higri potential fot future problems. No major upgrading of system is required at
this time.
� 4 System may , may not meet current City standards for desibn,consLruction or location, but is failing to properly treat and
dispose of the icurrent input,and is endangering a water supppy,or is Is source of pollution to surface or groundwaters,or is
creating a saf y hazard,or is otherwise creating a public nui nce.Please contact the City Inspector to discuss system repair/
replacAment p cedures. If drainfield replacement is necessa�soiF tea'ting will usually be required,and a desig�and site plan
must be submi ted for review.Your contractor must obtai�a p�rmit before work is started.
SYSTEM CONDITION (m Ch cked items may require your action) I I
Tank inspection indicates: ❑IlnspectiOn pipe is located directly over tank baffle.(Does not
��Pumpout not needed at is time. �give accwrate measurement of solids accumulation.) If tanks
Solids aecumulation in nks indicates they should be pump- �have no; been pumped out within the last three years,they
ed out this year to help event future problems, ishould be pumped out now.
❑ Solids accumulation in tanks is at a critical level, Tanks Drainf�eld inspection indicates:
ahould be pumped out as soon as possible. ��rainfielkl is dry,no surfacing evident.
❑ System is discharging t surface. Tanks must be pumped ❑ ome evidence of surfacing,not critical yet.
within 48 houro to elimi te surface discharge. ❑ IDrainfield is seturated and visibly discharging untreated
❑ Inspection risers miui —tanks could not be inspected. bffluent to the surface. This condition mey require replace-
Inspection risera (4"dia. pipe)must be installed in each tank ment or!additions to drainfield. Contact the City I�spector .
at next pumpout. If tan have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they ould be pumped out now. ❑ DrainfielH extent and condition unknown.
SITE CHARACTERISTICS:
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil typea,water Future Expansion
❑ Soil table and system condi�ion) �Adequate
❑ High water table � Low Fair
❑ Lot size ' Medium O Poor
O Lake,wetland,or stream � High ❑ Inadequate
❑ Drainage , ❑System is ceusingjvisible
surface dischar .�
COMMENTS: ��f � � / ►� �
.� ,.
� ate of Inspection pt�c System Inspector
i
Note: In the event that this ins ction report is used to satisfy the requiremen{s for a rrhortgage or other transfer of property,be advised that
this report does not guarantee o' certify that an existing system will continue tlo functiOn properly,but is merely an opinion of the adequacy
of the system under current con �tions based on the available inform8tian. i '
Thi report must be kept on the premises with syste locatiqn and pumping records.
WHI IE COPY/Inspector's File G(JLD COPY!Homeowner
�
f � �
On the North Shore o f
Lake Minnetoyzka
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
� _ � � 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357
OWNER ADDRESS ��� D Sh��l r��1
PERMIT NO.'S. DATES CONTRACTORS
City Ordinance No. 210 requires that each on-site sewage 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 category checked below.
(This is ❑ an existing system ❑ new construction)
� � Meets or exceeds 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 construction (1978 Code) but in most respects appears to be designed,
located, and constructed generally in accordance with previous codes. System appears to be functioning properly; 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 or 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 creati�g 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 baffle.IDoes not
❑ Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks
�Solids accumulation in tanks indicates they should 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 accumulation in tanks is at a critical level, Tanks Drainfield inspection indicates:
should 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 critical yet.
within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
❑ Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risers (4" dia, pipe) must be installed in each tank ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed witt�in 90 days.
the last three years,they should be pumped out now. �Drainfield extent and condition unknown) ��f(� S��t v�
r
SITE CHARACTERISTICS: � �� `�U-��1��'��
�
Limiting Site Factors Potential for System Failure Site Capabilities for
�Slope (depends on soil types,water Future Expansion
5oil table,and system condition) ❑ Adequate
❑ High water table ❑ Low ❑ Fair
❑ Lot size ❑ Medium ❑ Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑ System is causing visible
surface discharge.
COMMENTS:
�}�LL� �/
d�';
Date o Inspection � e`ptic System n ector
._./
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 existing 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
'"__ �-pl.k�-�/L G/� f �-C r��� � Vr�l C".l���— 1.f3 S T- ---
On the North Shore o f
Lake Minzzetorzka
31TE SEWAGE TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
� _ � � 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357
�ER �R.�DFaR/� �rTE�C'�nn� a�oREss .�%�v��' °->/(�liL�/✓ l�i�
IMITNO.'S. J l�JC� DATES � � � S CONTRACTORS �''��v�r`-S°i�
City Ordinance No. 210 requires that each on-site sewage treatment system i�Orono be inspected on a regular basis.The on-site sewage
:ment system at the above dress has been inspected and appears to fall into the category checked below.
(This is an existing system ❑ new construction)
� � Meets or exceeds 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 construction (1978 Code) but in most respects appears to be designed,
located, and constructed generally in accordance with previous codes. System appears to be functioning properly; 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 or 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.
!STEM CONDITION ( m Checked items may require your action)
3nk inspection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not
❑ Pumpout not needed at this time. give accurate measurement of solids accumulation.) If tanks
❑ Solids accumulation in tanks indicates they should 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 accumulation in tanks is at a critical level. Tanks Drainfield inspection indicates:
should 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 critical yet.
within 48 hours to eliminate surface discharge. �-� Drainfield is saturated and visibly discharging untreated
�C/T Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risers (4" dia. pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they should be pumped out now. ❑ Drainfield extent and condition unknown.
31TE CHARACTERISTICS:
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil types,water Future Expansion
❑ Soil table,and system condition) ❑ Adequate
❑ High water table ❑ Low ❑ Fair
—� Lot size ❑ Medium fl Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
� Drainage --`� System is causing visible
surface discharge.
)MMENTS:
/�� � ��' ����� �, �
Date of Inspection ptic System Inspector
In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that
�ort does not guarantee or certify that an existing system will continue to function properly,but is merely an opinion of the adequacy
ystem 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
i
. — � �
� SEPTIC SYSTEMINVENTORY
�
Address: 2160�hevlin Dr. PID: 03-117-23 34 0019
Building Type: � residence BRs Install'd for: 4 In Musa: Yes
Permit#: 3709 j Date of Permit: 7/17/73 Installer: Ouverson Exc.
System Type: sta�tdard trench Experimental: no Appliances: lndry,dshw
SYSTEM CONDI�'ION
Conformity: 3 ' Tank Condition: 5 DF condition: 11 Failure Pot: medium
SEPTIC TANKS '
Material: concrpte block Capacity: 1000, 1000
Setback to Bldg: 'i Cesspool:
DRAINFIELD 1
Length of Lines: # Lines: Trench Width:
Treatment Area: Type of Filter: Soil Boring: yes
Tile.Size: Under Tile: Perc Rate:
Setback DF-Bldg: DF Ht above Wt: 0
Soil Type: loam, �Clay loam Limitations: water table
�
;
WELL DATA
Setbacks - Well-Ta$�ks: 50 Well-DF: 70 Report in File yes
Pump Type: subrr�. Depth: 164 Diameter: 4 Method: drilled
�INSPECTION RECORD PUMPOUT RECORD
DATE DES�CRIPTION COMPLIANCE DATE GALLONS
7/11/78 no sur�'acing s 12/28/79 2000
5/16/84 no sur�'acing 2 3/16/92 2000
7/23/86 DF surlfacing 4 5/11/95 2000
7/29/88 no sur$acing 2 5/6/96 2600
6/29/90 no surfiacing 2
3/16/92 pipe replaced from ist tank to DB,pumpe 2
3/4/93 non-cohforming-repair by 12/31/95 3
10/5/94 non-conforming-repair by 12/31/96 3
11/7/97 non-compliant-repair by 12/31/2001 3
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SEPTIC S
Address: 2160 Shevlin Dr. PID: 03-1 17-23 34 0019
Building Type: residence BRs Install'd for: 4 In Musa: Yes
Permit#: 3709 Date of Permit: 7/17/73 Installer: Ouverson Exc.
System Type: standard trench Experimental: no Appliances: lndry,dshw
SYSTEM CONDITION
� Conformity: 3 Tank Condition: 5 DF condition: 11 Failure Pot: medium
SEPTIC TANKS
MateriaL• concrete block Capacity: 1000, 1000
Setback to Bldg: Cesspool:
,r
DRAINFIELD
Length of Lines: # Lines: Trench Width:
t,; Treatment Area: Type of Filter: Soil Boring: yes
Tile Size: Under Tile: Perc Rate:
Setback DF-Bldg: DF Ht above Wt: 0
Soil Type: loam, clay loam Limitations: water table
WELL DATA
Setbacks - Well-Tanks: 50 Well-DF: 70 Report in File yes
Pump Type: subm. Depth: 164 Diameter: 4 Method: drilled
INSPECTION RECORD PI�MPO UT RECORD
DATE DESCRIPTION COMPLIANCE DATE GALLONS
7/11/78 no surfacing s 12/28/79 2000
5/16/84 no surfacing 2 3/16/92 2000
7/23/86 DF surfacing 4 5/11/95 2000
7/29/88 no surfacing 2 5/6/96 2600
6/29/90 no surfacing 2
3/16/92 pipe replaced from 1 st tank to DB,pumpe 2
3/4/93 non-conforming-repair by 12/31/95 3
10/5/94 non-conforming-repair by 12/31/96 3
11/7/97 non-compliant-repair by 12/31/2001 3
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