HomeMy WebLinkAboutseptic info , Septic Tank Pumping / Maintenance R����v��
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JUL 0 6 Z011
Owner Information
Date: �n �.�d . ) '7 C1TY OF O ONO
Owner: Doboszenski&Sons
Property address: Owners address: (if different)
1700 Shoreline Dr
Orono,MN 55391
Reason for Pumping: ❑ compliance inspection ❑ hold.ing tank ❑ maintenance
Method of access: � manholes ❑ inspection pipe(holding tanlcs only)
(owner signature req'd if refusing to allow pumping through maintenancc hole)
Condition of tanks:
filter cleaned: Yes baffles good: Ves alarm working: Yes
No No No
n/a n/a n/a
Tank leakage observed: above operating depth: Yes tvo (repairs recommended)
below operating depth: ves No (failing to protect groundwater)
Gallons removed:
#1 U� #2 /$l�J #3 #4 ptunptank_� total��'�
Disposal method: municipal � location: [,�f���,. -�-�w�
land apply ❑ location:
Safety concerns:
Recommended repairs:
Comments: _�'
- 1 BiN� Gt�n��o,dm�.�'i'
!hereby cer1�tha11 have completed this work in accordance with MN 7083.0770 and any loca!requirements.
No delermin ' or guarantee ojfuture sys�em performance has been nor can be made.
Kothrade SWE, MPCA#0192 763.498.8702
Maintainer s' ature Company Phone number
� Minnesota Pollution SSTS Abandonment
Control Agency
420 Lafayette Road North Reporti ng Fo rm
St Paul,MN 55155-4194
Subsurface Sewage Treatment Systems (SSTS) Pr+ogram)
Instructions
This form is offered to meet the abandonment requirements of AAinn.R.7080.2500 and Disdoeure Requiremenb of Minn.Stat
§115.55,subd.6.Future water supply well placement can also be affeded by an abandoned SSTS.
The use of tMs form is not mandatory;however the infonnatlon on this fortn must be submitted to the local government unit(L�U)
within 90 days aPoer the abandonment.This fam may be comple�d by a c�e�ifled SSTS pracMioner or by an indivldual who has
dired knowledge of how the ayste�n was abandoned.
Property Information
(P-��t7 Idew Home Devel m
Date of abandonme�rt - - Reason for abandonment: op ent
Property owner name(s): Irwin 8 Alexandra Jacobs
Prop6Rr owners address:
City: StaGe: Zip:
Site address(if different): 1700 Shoreline Or
City: Orono g��; MN Zip; 55391 .
Compliance Information
1. All solids and liquida removed irom all tanks? �$Yes ❑No
Disposal Site:
2. Ali electrical devk;es arul deviaes�ntaining mercury r�wved? ❑Yes ❑No N/A
Disposal Site:
3. Ali underground sewage fanks crushed and fllled with soil or rodc material? �Yes ❑No or
Removed and dispaged oif site? ❑Yes �$No
Di�osel Site:
4. Contaminated materials'removed and disposed off site? (�Yes ❑No
Di�Osal Site:
5. All underground cavilies"crushed and filled with soil or rodc material? �Yes ❑No or.
Removed end�Sposed otf site? ❑Yes �No
Disposal Site:
8. Future discharge to system permanenHy denied? �Yes ❑No
Method(s)used:
•Concmrtinated rrwterlafs= DtsMbution rt►ediQ,soil or wnd wJthin three feet of the system bottan,dlstrlbudon plpes,gentextlte
jabrlc/rasfn pcpsr/straw,tanks�contaminoted soft around teakrng tanks,arry soll that recNred sewage
fram c surjoce jallure(7i0B0.2500 wbp.3).
"Underground cnvldes e Cesspools.leaching plts,drywe(Is,seepage pits,vmelt prlvies,pit prlvles,pwnp chmnben
(7060.2500 subp. 1).Does not fndude chamber medlc,drop boxQs,or dtstributlon boxes.
www.pca.state.rt�.us • 651-296-63Q0 • 800-657-3864 • TTY 651-282•5332 or 800-657-3864 • Available in altemative fortnats
wp-wwlsts4-03 • f 1/2i/OB Poye 1 of 2
Map
Include location of building sewer, septic tank(s), soil dispersal system, cesspools,seepage pits, and other pits. Also
include a permanent reference point(s) and dimensions.
T North
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Certification
!hereby certify the system was abandoned in accordance with Minn.R. 7080.2500 and any local requirements.
Name(please print): Glen Kothrade Tt1e; President
Address: 12059 Whitetail Ln
��ty; Hanover __ State: MN Zip: _55341 `
Phone: 763.498.8702 L' e#' i I ): �92
Date: (,Q '�"(, Signature:
www.pca.state.mn.us • 651-296•6300 • 800-657-3864 • TTY 651-282•5332 or 800•657-3864 • Available in alternative formats
wq-wwists4•03 • 11/21/08 Poge 2 of 1
Doboszenski & Sons-Property Development 2017
_,
(�����)
2017 SEPTIC MAINTENANCE REPORT
Date of Pumping: 06- 20 7
Site address: 1700 Shoreline Dr
3-- f �'w
Number oftanks: ._,_ _ . ___ _ate last pumped: Gallons pumped: ��^UJ
Name of pumper/mairrtenance provider: Kothrade SWE. Inc. #0192 / Lam Bursch#9199
Are tanks watertight?: YES NO
(please arcle one)
Is the system functioning prope�iy? �P,S
(ie slow drainage,wetness in the drair�field?)
Do you have any concems or issues that you'd like to discuss with the SSTS Program Manager?
If so, please indicate best time and telephone numbe�(s)to be reached between 8 am and 4:30 pm.
Name Telephone Number(s) Best Time to Call
RETURN IN THE ENCLOSED ENVELOPE
AS SOON AS POSSIBLE
WILLIE GIBBS
CITY OF ORONO
PO BOX 66
CRYSTAL BAY MN 55323-0066
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� � GiTY o� oRONo
1( � ,iA`�f` .
1 �
��,� �;�� ,, t �� Mwucipeloffices
��� ��, x�' ��"d '�,I� �� Post Office Box 66
� iI�Y�•" � '"��� 1r G �i Crysta!Bay,h9innesota 55323-0066
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��kESHO ��';
December 8, 1994
Irwin Jacobs
Attn: Christine Bergmann
1700 Shoreline Drive
Wayzata, MN 55391
Dear Ms. Bergmann:
T'he City requires a permanent septic system for the guard shack at 1700 Shoreline Drive. In
our earlier discussions, the system was to be upgraded this year at the same time the main house
system was being replaced. The septic system for the main house has been completed, but the
current climate conditions would make upgrade of the guard shack system more difficult. In
order to assure the timely completion of the required septic sy�tem improvements, a June ?S,
1995 repair deadline has been set.
Please contact me at the City offices if there are any questions.
Sincerely,
'
. �/�7���y�_
Stephen Weckman
On-Site Systems Manager
SW/lsv
TEI.EPHOIVT-473-7357• FAX-473-OS 1Q
N�
��.IS'�E�,� LOCATION a��
INSPECTION RECORD PUMPOUT RECORD ��,J��,� P SKETCH � ��
DATE COMPLIANCE DATE GALLONS " � ��/, �
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CITY OF ORONO Date
ADDRESS � Connected to
CODE SEPTIC SYSTEM INVENTORY CARD Municipal Sewer
�YS%�l''� — N�>l:'_r' %�_�
Address / 7�V �%�f�L.�/�-'�L�'/�/� Property I.D. �d'"���'Z.3 �7 ���� .� WELL DATA
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System type ❑ Other Legal Description S�C�� �� � �
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Permit No. " or�� Date of ermi �
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SEPTIC TANKS: M e ia ity )✓���0 -~ 2) ° � � •o
'To 7�P oF i qNK �. � d
Proper ou et a d' t B Ies Liquid depth to RO level � •
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H ght of tan ottom a ve er table _ Distance to nearest building g� � N �
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DRAINFI LD: otal I gth of lines Number of lines Trench width �
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Type of 'ter ate al Soil type ua, ^�
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Distance ro n rest dg. Tile size Perc rate min/in ° a ,��, c
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Depth of ove drai eld Depth of rock over tile under tile � a y "
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SEPTIC SYSTEM INVENTORY
site nddress: 1700 Shoreline Dr PID: 1011723140014
Owner Name: Irwin L.Jacobs
Owner Address: 1700 Shoreline Dr Wayzata MN 55391
Building Type: residence Installer:
Date of Permit: 9/29/94 Widmer Bros.
System Type: mound BRs Designed fo�: 4
In Musa?: Yes Shoreland?:
SEPTIC COMPLIANCE INSPECTION ,
Report Date:
Compliant Expires:
Non-Compliant?: Report in Street File?:
SPECIAL NOTES Site Address: 1700 Shoreline Dr
03/16/09 2009 Septic Maintenance Report Letter Sent
SEPTIC TANKS
Material: precast concrete Capacity: 1000, 1000, 1000 Tank Filter:
DRAINFIELD
Treatment Area: 80"36 Soil Boring: yes DF Ht above Wt: 3
WELL DATA
Setbacks-Well-Tanks: Well-DF: Report in File?: Depth: 230
INSPECTION RECORD PUMPOUT RECORD
Date Descriqtion Date Gallons
12/8/94 installation 04l25/95 1000
10/20/97 no surFacing 04/02/98 2000
6/27l00 no surfacing 08/21/06 4000
10/02/02 no surfacing 09/25/07 5000
12/01/06 Okay
4/1/2009
3:49:20 PM
.—_---
,:; �_ �^
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� :.: � . .� ��� ciTY �� o�o�v�
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„ ��: �..t�`�'Y ,y,�;i
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, ,� ;�: ^� � ,;, ��,;; Municipal Offices
�'� � ' �� � ,.�� �`'� G �`1 Street Address: Mailing Address:
�'4kEsKp4�'� 2150 Kelley Parkway P.O. Box 66
_.__.. .._ Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Cunent Owner of Address � y7G� �4t� '�'e /.�'U�
City Ordinance requires that onsite sewage treatment systems in Orono be
inspected on a periodic basis. The onsite sewage treatment system at the above
address has been inspected and the following is known about the system. A
sketch of the known components of the system is available for most properties at
the Orono City Hall.
Imminent Public Health Threat
Yes
No
If yes, please contact the Onsite Systems Manager at 952-249-4626 within 10
days of recei�t of this notice. The septic system must be brought into compliance
within 90 days. Failure to do so will result in referral to the City Attorney for
legal action.
System Identified as Non-Compliant
Yes �� No
If yes, system rnust be brought into compliance by:
December 31, 2007 �
December 31, 2010
Other
Septic Tank(s)Pump out Needed
Yes �No
The City recommends the septic tank(s) and/or lift tank be serviced and pumped �
out every three years. City records indicate the tank(s) were last pumped out on
"�',�l—p� . The tank(s) should be cleaned throu�h the manhole and
not tlu•ou�h the inspection pipes, this allows for proper cleaning.
Comments:
� ��w ,
Inspe�,�,��e��'� �a���� Date of Inspection �� ' � �
1'efepi�onz f9�2) ?;9-460Q � �ax (9�2j 2�9-�blb
µ�r tis.ci.osono.mn.us
.� o,�,.
o��� o
�r�;�,.�� CITY of �R4N0
���� ��, ..��. �,
� 1• A:.
�� �`•�a�s~ ,y,�' Munlcipal Of�ices
��f�i�,I��+��r
��+.'�•x��Og�'yG Street Address: Mailln�Addreus
;�.r�ii
EgYi 2750 Kelley Paricway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
95d-�4q-4600
To Current Owner: Address: �706 S��t ��nC ��
City Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two years.
The on•site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYS'I'EM CONFORMI'TY (1-31: �
O "CODE SYSTEM"An ISTS which meet�a11 the location,daign and conswction standards of the cuaent Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the location,design and construction standards of the current Orono Municipa!
Code but does mcet the three foot separation requirement or two foot requirement for sysums installed 1996 or earlier,and which is not failing or
an imminent threat to public health or safery. -
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a daignated 100-yeaz fload plain,any ISTS which may
or may not meet a11 the location,design,or conswction standards of the cumnt Ocono Municipal Code and which is failing for any rcason;and
any ISTS with leu than tluee feet of unsaNrated soil or sand between the d'utribudon device and the limiting soil characteristics.
TANK CONDITION(_�-:7,�: �
Tank inspection indicates: .
5 Pumpout not needed at this time.
6 Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 yeazs.
Tank was last pumpzd y�2.'S R l.
Make sure seatic tanks are numoed through manhole and not throu¢h white insoection aiDes.
This allows for the proaer cleaning.
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
DRAINFIELD CONDITION[8-�Q�: ,�
8 Drainfield is dry,no surfacing evident.
9 Some evidence of surfacing,not critical yet. �
10 Drainfield is saturated and visibly discharging untreated ef�luent to the surface. Contact the City Inspector �
immediately.Repairs must be completed within 90 days.
co�rrrs: svsh�s � oo,� oIC_ p��p ��.Ir� �'�:5 �11_
� � -�-v�- �a�
Date of Inspection Matt Bolterman— Septic System Inspector
Note: In the event that this inspecdon rcport is used to satisfy the requinments for a moctgage or other transfer of property.be advised that this rcport does not guarantee
or certify that an eristing system will continue to function properly,but is mercly an opinion of the adequacy of the sysum under current wndidons based on the available
information.
� .�o�.
0 0
' �a-t ��- CITY of ORONO
, a��r�. � �,
' � ��� , � � -�. !S� Munici Otflces
'� � �.
'� '��t� �,,���, G�' �
'� � � n `r�. � Street Addrou: MaiNnQ Addrou:
�ygg0g' 2150 Kelley Pa�kway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323•0066
July 24, 2000
Irwin L. Jacobs
1700 Shoreline Drive
Wayzata, Mn 55391
Dear NIr. Jacobs:
An inspection of your septic system was conducted on June 27, 2000. A summary of the inspection
is beiow.
Septic Tank Condition (residence)
1. Pumpout not needed at this time.
The septic system is a compliant system, meaning it meets all or most current City and State
Standards. Enclosed is a list of licensed contractors who work in Orono on a regulaz basis. This
list is enclosed simply for your reference in case your septic system needs maintenance in the future.
Also enclosed is a fact sheet explaining your septic system and how it functions. Finally, an as-built
drawing is enclosed showina the approximate location of the septic system.
If you have any questions regarding this report, please contact me at the City Offices at 249-4600.
Res ectfull
. .��
Chris Pence
On-Site Systems Manager
Enclosures
In the event this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,
be ad�•ised that this report does no guarantee or certify the eaisting 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 the system location and pumping records.
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
� o�
�o 0
'� ', � CITY o� ORONO
�. :
, � � � t�, T
�i 13; _. i C "�
�
�� y � �t r, ��I MU�C�� ��CC.4
,t� � �� ���' „�Y"`�'�G SVeat Addross: MaiNn�Addrosa:
, . , �.
''$Egg04' 2150 Kelley Parkway P.O. Box 66
O�ono, MN 55356 Crystal Bay, MN 55323-0066
July 24, 2000
Irwin L. Jacobs
1700 Shoreline Drive
Wayzata, Mn 55391
Dear Mr. Jacobs:
An inspection of your septic system was conducted on June 27, 2000. A summary of the inspection
. is be�ow.
Septic Tank Condition (Guest Wing)
1. Pumpout not needed at this time.
The septic system is a compliant system, meaning it meets all or most current City and State
Standards. Enclosed is a list of licensed contractors who work in Orono on a regular basis. This
list is enclosed simply for your reference in case your septic system needs ma.intenance in the future.
Also enclosed is a fact sheet explaining your septic system and how it functions. Finally, an as-built
drawing is enclosed showing the approximate location of the septic system.
If you have any questions regarding this report, please contact me at the City Offices at 249-4600.
Respect ly,
� � /
�U�
ris Pence
On-Site Systems Manager
Enclosures
In the event this inspection report is used to satisfv the requirements for a mortgage or other transfer of property,
be udvised that this report does no guarantee or certify the eaisting system will continue to function properly,but
is merely an opinion of the adequacy of the system under current conditions based on the avail�ble information.
This report must be kept on the premises with the system location and pumping records.
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
; � °�
0 0
� .-s _
�� ��-- .���= � CITY of ORONO
�� ,, r=���, �
�;, � �� _.; ti M�� o���
�,� „�:�`:�?,� ti �
�� � ��=�,;:r"<��;�',�� Street Addrou: Mailina Addross:
�E+gg04' 2150 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323•0066
July 24, 2000
Irwin L. Jacobs
1700 Shoreline Drive
Wayzata, Mn 55391
Dear NIr. Jacobs:
An inspection of your septic system was conducted on June 27, 2000. A summary of the inspection
is belbw.
SeQtic Tank Condition (guest residence/guard house)
1. Pumpout not needed at this time.
The septic system is a compliant system, meaning it meets all or most current City and State
Standards. Enclosed is a list of licensed contractors who work in Orono on a regulaz basis. This
list is enclosed simply for your reference in case your septic system needs maintenance in the future.
Also enclosed is a fact sheet explainin�your septic system and how it functions. Finally, an as-built
drawin� is enclosed showing the approximate location of the septic system.
If you have any questions regarding this report, please contact me at the City Offices at 249-4600.
Re ectfully,
. �t�
C is Pence
On-Site Systems Manager
Enclosures
In the e�•ent this inspection report is used to satisfy the requirements for a mortgage or othertransfer of property,
be ad�ised that this report does no guarantee or certify the eaisting s�stem will continue to function properly,but
is merel�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 the system location and pumping records.
Telephone(952)249-4600 • Fax(952)249-4616
www ci.orono.mn.us
� o�
O '`a O
�-�`���� CITY of ORONO
1��'���.
1� �''t "�� �y
M�A ��� �'y r>�%`� �1r11 MUII1Cl� ��C@S
' y �•J .
�.�P�'� G Street Address: Mailina Addross:
`�Cj,+gg04'� 2150 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323•0066
Owner: ��W/� ✓�'��`-��S Address: 1700 Shoreline Dr.
Permit #'s: 3398 Dates: li/5/90 Contractors: Coppia Plbg.
(This is [J�] an existing system [ ] new construction) .
STEM COMPLIANCE (1-3) : 1
1 Code System: Meets 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.
3 Non-Compliant System: 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 [ �] has or [ ] has not been ideatified at this time. If the
saturated soil level has not beea ideatified, this claasi£ication is subject to revision.)
TANK CONDITION (5-9) : 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 o�t 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.
(DurinQ the last septic tank Maiateaance Pwqpout tha tanks [ ] were or � were not confirmad
to be waterti�ht by tha licensed Duu�piny contractor. If the tanks ware not confirmed to ba
watertiQht, this classification is subject to ravision.)
INFIELD CONDITION (11-14) : 11
1 Drainfield is dry, no surfacing evident.
2 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.
POTIIVTIAL FOR SYSTEM FAILURE: (system age and condition, soils, etc.) : low
CONIMENTS:
ro-�--9� .
Date of Inspection Se 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, but indicates the operation of the system under current conditions.
Tetephone (612) 473-7357 • FAX 473-0510
�O�
O �: O
��--� CITY of ORONO
�
'r�'+� �,� �. �' ``` ,�l�r Municipa! Offices
�.� � a� � �.�G Street Addnss: Mailing Address:
9$E gg O g' 2 7 5 0 K e l ley Par kway P.O. Box 6 6
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: �l `+J�� 1 �C.� Address: 1700 Shoreline Dr.
Permit #'s: 6482 Dates: 9/29/94 Contractors: Widmer Bros.
(This is [�] an existing system [ ] new construction) .
SYSTEM COMPLIANCE (1-3) : 1
1 Code System: Meets 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.
3 Non-Compliant System: 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 �] has or [ ] has not baea ideatified at this time. If the
saturated soil lavel has not been ideatified, this classificatioa is subject to ravision.)
TANK CONDITION (5-9) : 5
5 Pumpout not needed at this time.
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 ths last saptic tank Maiatenance Pua�out tha tanks [ ] were or [ ] ware not con£ira►ed
to be watertiQht by the licensed puaSpinQ coatractor. I£ the taaka werA not confirmed to be
watartight, this classification is subject to revision.)
INFIELD CONDITION (11-14) : il
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 FAILURE: (system age and condition, soils, etc.) : low
COMMENTS:
�� - `;�
�
Date of Inspection Sep i 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, but indicates the operation of the system under current conditions.
Telephone (612) 473-7357 • FAX 473-0510
�°�
O �:.�,,a O
��_�-� CITY of ORONO
,� ���� :� �
� `�, I '`'�' �l5r Municipal Offices
' ti •::f�
� '" G
,t a ' .`y Street Address: Mailin�Address:
''��gOg' 2150 Kelley Pa�kway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: �' �""� ����� Address: 1700 Shoreline Dr.
Permit #'s: 8786 Dates: 11/13/86 Contractors: Coppin Plby.
(This is [�] an existing system [ ] new construction) .
STEM COMPLIANCE (1-3) : 1
1 Code System: Meets 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.
3 Non-Compliant System: 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 saturatad soil level (,�J has or [ ] has aot been identi£ied at this time. IE the
saturated soil level has not bean ideatified, this classification is subject to revisioa.)
K CONDITION (5-9) : 5
Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they stiould 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.
(DurinQ tha last septic tank Maintenance Pumpout the tanka [ ] were or (x] were aot confirmed
to ba watertiQht by the licensad pwqpinQ contractor. If the tanks ware not coafirmed to be
watartiyht, this classification is subject to revision.)
,��INFIELD CONDITION (11-14) : 11
(1J.+ 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 FAILURE: (system age and condition, soils, etc.) : loW
COMMENTS:
L� ��! �
Date of Inspection ptic 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, but indicates the operation of the system under current conditions.
Telephone (612) 473-7357 • FAX 473-0510
CITY OF ORONO �O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 a � ON—SITL SEWA(;E TREAZ�N'!.'
r�`,� � INSPECTION REPORT
� G�
�9kEsHo�'�
Owner: �L/1/V���GG7� Address: ��L�i .��P��P, JX: ��1��/�fr �01��
.�...������
Permit #'s: ates: ��g� Contractors: �YYt/ .X�ykSdV\
City ordinance rnanber 100 requires that each on-site sewage treatment system in Orono be inspected on a regular besis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is D�} an existing system [ ] new construction)
SYSTEM CODIFORMITY (1•3):
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING S1'STEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in etfect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface uaters.
3 "NON-CONFORMING SYSTEM��-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or mey not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any_system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
� (7he limiting soil characteristic�has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION C5-10):
Tank inspection indicates:
Pu�out not needed at this time.
6 s accunulation in tanks indicates be out this year to help prevent f
So � s n in an s is a a critica eve an possib e. ' �
8 System is discharging to the surface. Tanks must be punped out within 48 hours to eliminate surface dischar$e.
9 [nspection risers missing-tanks could not be inspected. lnspection risers (4" dia. pipe) must be installed in each
tank at next punpout. If tanks have not been p�mped out within the last three years, they should be punped
OUt nOM.
10 Inspection pipe is loceted directly over tank baffle (does not give accurate measurement of solids accunuletion).
If tenks have not been punped out within the last three years, they should be pu�ed out now.
DRAINFIELD CONOITION C77•14):
D�ey�field inspection indicates:
C]9 Drainfield is dry, no surfacing evident.
�f2 Sane evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibty discharging untreated effluent to the surface. Contact the City lnspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown,
LIMITING SITE FACTORS Csloce,setbecks.etc.):
POTENTIAL FOR SYSTEM FAILURE (deoends on soils,water table,etc.):
CO TS: +
�
N
Date of Inspection Se ic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortga e or other transfer of
property, be edvised that this report does not guarantee or cert�fy that an existing system wi�l continue to f�ction
properly� but is merely en opinion of the adequacy of the system �der current conditions based on the available
tnformetton.
This report must be kept on the premises with the system locstion and punping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
CITY OF ORONO �O�
Municipal Oftices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWA(�E TREATMENT
v�`,, � INSPECTION RBPORT
'C�� G~
�kEsao4`'�
Owner:�Y'�1���'�°l?� Address:��' J/li l.E l� 1
Permit #�'s: Dates: ���.SL'��_Contractors: �Gtl�f�l�
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewege 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)
SYSTEM CONFORMITT (1-3):
"COOE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
. current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input Without discharging
any pollutants into ground or surface uaters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which mey or mey not meet alt the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any.system with less than 3 feet of unsaturated soil or �and
between the distribution device and the limiting soil characteristics.
(The limitin� soil characteristic ,p�has or [ ] has not been identified at this time. If the timiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-10): �
T�c inspection indicates:
(,�/ Punpout not needed at this time.
6 Solids accumulation in tanks indicates they should be punped out this year to help prevent future problems.
7 Solids accunulation in tanks is at a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be punped out within 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. lnspection risers (4" dia. pipe) must be instelled in each
tank at next punpout. lf tanks have not been pumped out within the last three years, they shaild be punped
out now.
10 inspection pipe is loceted directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been punped out within the last three years, they should be punped out now.
DRAINFIELD CONDITION (11-14):
Drp�n field inspection indicates:
(1V Drainfield is dry, no surfacing evident. .
"IZ Sane evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
IIMITING SITE FACTORS (sloce.setbacks.etc.):
POTENTIAL FOR SYSTEM FAIIURE (decends on soils,water table.etc.): P��
COMMENTS:
Date o inspection S tic 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 cert�fy that an existing system will continue to function
properlyi but is merely an opim on of the adequacy of the system under current conditions besed on the availabte
informet�on.
This report must be kept on the premises with the system locetion and p�mping records.
WHITE COPY/Inapectors Flle YELLOW COPY/Homeowner
CITY OF ORONO �O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWAOE TREATMBNT
r�, � INSPECTION REPORT
� G�
��kEsH.o�'�
Owner: _�l�/�W// \�JC����Address: / /l�I_J ,�a��OYF./!�P /��i �� S� ��,�
Permit #'s: .�9g Dates: �/�9D Contractors: CS��I� �,DA�
City ordinance number 100 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)
S1'STEM CONFORMITY (1-3):
1 �'CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and �ich
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or mey not meet all the location, design, and construction standards of the current City
Codes and which is faili for any reason; and any system with less than 3 feet of w�saturated soil or sand
ur
between the distribution evice and the limiting so�l characteristics.
(The limiting soil characteristic �1 has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-10):
Tynk inspection indicates:
(� Punpout not needed at this 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. Tanks should be punped out as soon as possible.
8 System is discharging to the surface. Tanks must be punped out within 48 hours to etiminate surface dischar$e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) �st be installed in each
tank at next pumpout. If tenks have not been punped out within the last three years, they should be punped
out now.
10 Inspection pipe is tocated directly over tank baffle (does not give accurate measurement of solids accunulation).
tf tanks have not been pury�ed out within the last three years, they should be punped out now. "
DRAINFIELD CONDITION (11-14):
Dr field inspection indicates:
�Drainfield is dry, no surfacing evident.
12 Sane evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repeirs must be completed within 90 days.
14 Drainfield extent and condition �mknown.
LIMITING S1TE FACTORS Csloce,setbecks.etc.):
POTENTIAL FOR SYSTEM fAILURE (deoends on soils.water table,etc J: ��
COMMENTS:
Date o Inspection e ic 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 existing system will continue to function
properlyi but is merely an opim on of the adequacy of the system under current conditions based on the available
informetion.
This report must be kept on the premises with the system locetion and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
CITY OF ORONO �O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITF SEWA(;E TREA'1'l�NT
� �ti.
INSPECTION REPORT
'�' G
�9kESHo�'�
Owner:��t//�'�` Y�/'� Address: / .(.T.�/ �a/Y��/1��P �l N. �/��lt� /C�S�!%���
Permit �'s: � Dates: �//�� Contractors: S�//Jf.f3i'1�
City ordinance nunber 100 rec�uires that each on-site sewage treatment system in Orono be inspected on a regular besis.
The on-site sewage treatment system at the above address has been inspected and appears to falt into the category
checked below.
(This is �L an existing system [ ] new construction>
STSTEM CONFORMITT (1-3):
1 °CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into gro�d or surface waters.
2 "CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standerds of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
1 is operating satisfactority by treating and disposing of the entire current sewage input without discharging
n) any pollutants into ground or surface waters.
(3J "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the locetion, design, and construction standards of the current City
Codes and which is failing for any reason; and any_system with less than 3 feet of �saturated soil or sand
between the distribution device end the limiting soil characteristics.
(The limitin� soil characteristic [ ] has or�has rwt been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION C5-10): �
Tank inspection indicates:
5 Pumpout not needed at this time.
6 Solids accunulation in tenks indicates they should be punped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible.
8 System is discharging to the surface. Tanks must be punped out within 48 hours to eliminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) must be installed in each
tank at next punpout, tf tanks have not been punped a�t within the last three years, they should be punped
out now.
1 Inspection pipe is txated directly over tank baffle (does not give accurate measurement of solids accunulation>.
1f tanks have not been punped out within the last three years, they should be punped out now.
DRAINFIELD CODIDITION C11-14):
Dreinfield inspection indicates:
11 Drainfield is dry, no surfacing evident.
� Some evidence of surfacing, not critical yet.
Drainfield i nd visibly discharging untreated effluent to Contact the City inspector
i �ate y. Reaa�rs mus .
14 Drainfield extent ana cona . --
11M1TING S1TE FACTORS Csloce.setbecks.etc.):
POTENTIAL FOR SYSTEM FAILURE (decends on soils.water table,etc.):
COMMENTS: ��gp�,� �QC1�/����1�Y_�0 CN���,�"f'7��,q•
Date of Inspection S ic 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 edvised that this report does not guarantee or certify that an existing system will continue to f�ction
properly� but is merely an opin�on of the adequacy of the system under current conditions based on the available
informetion.
This report must be kept on the prerises with the system locstion and punping records.
WHITE COPYllnapectors Flle YELLOW COPY/Homeowner
On the Nortb Shore o f
Lake�Iinnetonka
ON-SITE SEWAGE �REATMENT
INS'PECTION REPORT � POST OFFICE BOX 66
� . � � 1335 S. Brown Rd.
Crystal Bay,MN 55323
� 473-7357
OWNER TI^!�//l�r� L. .T?['i� ADDRESS ���� �7,._Y3rP/1�/�Q�
PERMIT NO.'S. �/�� DATES �/��� CONTRACTORS
City Ordinsnce No.210 requirea that each on-site sewage trestment system in Orono be inspected on a�egular besis.The onsite sewage
treatment system at the above addreas has been inspected and appeare to fall i�to the category checked below.
(This ia � an existing system ❑ new construction)
�( � Meets or exceeda current City atanderds in all reapects 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 sccordance with previous codes.Syatem appeara to be functioning properly;no major
upgrading of the system is required at this time,
� 3 Does not meet current City atandards 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
thia time.
� 4 System mey or may not meet current City atandards for design,construction or location,but is failing to prope�ly 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 nuisence.Pleaae contact the Ciry Inspector to discuss system repair/
replacement procedures. If drainfield replacement is necessary,soil testing will usuelly be required,and a design and site plan
muat be submitted for review.Your contractor must obtain a permit before work is started.
SYSTEM CONDITION (m Checked items may require your action)
Taek inspection indicatea: ❑ Inapection pipe is located diroctly over tank baffle.(Does not
� Pumpout not needed at this time. give accurate measureme�t of solids eccumulation.) If tanks
❑ Solida atxumulation in tanks indicatea they should be pump- have noi been pumped out within the last three yesrs,they
ed out thia year to help prevent future problams. should be pumped out now.
❑ Solids eccumulation in tanks is at a critical level. Tanks Dreinfield inspection indicetea:
should be pumped out�aoon�posaible. �Dreinfield is dry,no surfacing evident,
❑ System is diacharging to surface. Tanb must be pumped Some evidence of surfacing,not criticsl yet.
within 48 hours to eliminate surface discharge. O D�ainfield is saturated and visibly discharging untreated
O Inspectio� risers missing—tanks could not be lnapected, effluent to the aurf�e, 7his condition may require replace-
Inspection ri�n (4"dia.pips)muat be inatslled in each tank ment or additions to drainfield. Contect ths City Inspector
at next pumpout. If tsnks have not been pumped out within immediately.Repeirs must be completed with'in 80 days.
the last three yean,they thould be pumped out now. ❑ Drainfield extent and condition unknowm.
SITE CHARACTERISTICS:
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil typea,water Future Expansion
❑ Soil table,and system condition) �Adequate
❑ High water table Low ❑ Fair
� Lotsize �Medium O Poor
❑ Lake,wetland,or stream ❑ High . ❑ Inadequate
❑ Drainage ❑System is causing visible
surface discharge.
COMMENTS:
9=/a-90
Date of Inspection Septic System Inspector
Note: In the event that this inspection re�rt 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
i_
On the North Shore o f
Lake Minnetonka
ON-SITE SEWAG� TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
� . � � 1335 S. Brown Rd.
�� //�;�rl ���r Crystal Bay,MN 55323
r� 473-7357
/ /�_ /�Q►%'�
OWNER •�Yl���n !, .T�' S' ADDRESS I� ����i� �l'. C �ov�e�
PERMIT NO.'S. DATES l� �g�� CONTRACTORS -�//�vB�
City Ordinance No.210 requires that each on-site sewage trestment system in Orono be i�spected on a repular basis.The on-site sewage
treatment system at the above addrea has been inspected and sppears to fall into the cetegory checked below.
(This is � an exiating system O new consuuction)
� � Mests or exceeda current City stan�rds in all respects relating to deaign,construction,and location.Appears to be operating
properly.
�2 Does not meet all current City standerds for new construction (1978 Code) but in most respects appears to be designed,
located, and constructed generolly in accordance with previous codea.Syatem appears to be functioning properly;no major
upgrading of the system is required at thic time.
� 3 Doea not mest current City etandards in many respects relating to design,construction,or location.Appears to be operating
adequately at this time,but has a reiatively high �tential for future problems.No major upgrading of system is required at
this time.
� 4 System may or may not meet current City ttandards for design,construction or location, but is failing to properly treat and
diapose of the current input,and is endsngering a water supply,or is a source of pollution to surface or groundwaters,or is
creating a eafety hazard,or ia otherwise creating a public nuisance.Please contect 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
muet be submitted for review.Your contractor must obtain a permit before work is atarted.
SYSTEM CONDITION� m Checked items may require your action)
Tank inspection indicates: �� Inapection pipe is located directly over tank baffle.(Does not
❑ Pumpout not needed at this time, givs accurate me�urement of solids accumulation.) If tanks
❑ Solid�accumulation in tanks indicates they should be pump- have not been pumped out within the lest three years,they
ed out this yur to help prevent future problems. should be pumped out now.
❑ Solid� accumulation in tanks ia at a critical level, Tanks Drainfield inspection indicatea:
should be pumped out as aoon aa possible, lS Drainfield ia dry,no surfacing evident.
� System is diacharging to eurfa�. Tanks muat be pumped ❑ Some evidena of surfacing,not critical yet.
within 48 houn to eliminate surface discharge. ❑ Drainfield is aaturated and visibly discharging untreated
❑ Inspection risen miaing—tanks could not be inapected, effluent to the aurface. This condition may require replece-
Inspection ri�n (4"dia.pipe)must be instelled in each tenk ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanks have not been pumped out within immediately.Repain mwt be completed within 90 days.
the last three yean,they should be pumped out now. ❑ Drainfield extent and conditio�unknown.
SITE CHARACTERISTICS:
Limiting Site Factors Potential for System Faiture Site Capabilities for
❑ Slope (depends on soil types,water Future Expanaion
❑ Soil tabte,and system condition) $1 Adequate
❑ High water table �Low ❑ Fair
❑ Lot size O Medium 0 Poor
❑ Lake,wetland,or stream ❑ High . ❑ Inadequate
❑ Drainage ❑System is causing visible
surface discharge.
COMMENTS: �/ 'e ��/ �
�'r��s���a`,� �r� c�n�
9�D-�D
Date of Inspection Septic System Inapector
Note: In the event that this inspection report is used to satisfy the reQuireme�ts for a mortgege or other transfer of property,be advised that
thia 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 o�the premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner
.
On the North Shore o f
Lake�finnetonka
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
1335 S. Brown Rd.
' ' ' Crystal Bay,MN 55323
473-7357
OWNER .�r���TAc�s ADDRESS I l���� (X1
PERMIT NO.'s. 33qg DATES J�� `�� CONTRACTORS
City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular besis.The on�site sewage
treatment system at the above address has been i�spected and appears to fall into the category checked below.
(This is ❑ an existing system Q� new construction)
�� Meeu 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 standerds for new co�struction (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 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'nspection 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 ia at a critical level. Tanks Dr$infield inspection indicetea:
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 surfecing,not critical yet.
within 48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
❑ Inspection risera missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risers (4"dia, pipe)muat 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, O Drainfield extent and condition unknown.
SITE CHARACTERISTICS:
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil types,water Futu e Expansion
❑ Soil table,and system condition) �Adequate
❑ High water table ��ow ❑ Fair
❑ Lot size ❑ Medium ❑Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑System is causing visible
surface dischar�.
COMMENTS: ��G ✓rY.�YYY1 i-OY' I�1'�UJ �1�'Q.5�1 I1DLlSY •
11-8—�D
Oate of Inspection Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other tra�sfer of property,be advised that
this report does not guarantee or certify that an existing system will conti�ue to function properly,but is merely an opinion of the adequacy
of the system under current conditio�s based on the available i�formation.
This report must be kept on the premises with system location and pumping records.
WHITE COPY!Inspector's File GOLD COPY/Homeowner
- On the North Shore o f
Lake Minnetonka
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT � POST OFFICE BOX 66
� _ � � 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-73575y�m�I—No��S�
OWNER r w t� �-- �aCOb� ADDRESS ��.(�'ZS�c����nQ ��►/�
PERMITNO.'S. � �, DATES 1 I � f g�`�'�5 CONTRACTORS Sl.clli✓Q�'1
City Ordinance No. 210 requires that each on-site sewa�trestment 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,conatruction,and location.Appears to be operating
propetly.
fJ'� 2 Does not meet all current City standards for new construction (1978 Codel but in most respects appears to be designed,
�G� 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 nLt meet curcent 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 weter 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.(Dces not
�Pumpout not needed at this time. ,� give accurate measurement of solids accumulation.) If tanks
❑ Solids aecumulation 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 aoon aa 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 risera miuing—tanks could not be inspected, effluent to the aurface. This condition may require r.eplace-
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 mint be completed within 90 days.
the last three years,they should be pumped out now. �(Drainfield extent and condition unknown.
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
❑ Hqgh water table ❑ Low � Fair
O Lot size �Medium O Poor
�7 Lake,wetland,or stream ❑ High . ❑ Inadequate
_ ❑ Drainage ❑System is causing visible
surface discharge. ,
COMMENTS: �Ip� ����L-- S(�(ZOfIP �'�n77�GT /Y)O��L�Ou� �_�OCQT/ON
, 7 7 /
8"' (�"�7
��
Date of Inspection Septi Syste ec r
Note: In the event that this inspection report is used to satisfy the ret�uirements for a mortgage or ther transfer of property,be advised xhat
this report does not guarantee or certify that an existing system will continue to functio�pfoperly,but is merely an opi�ion of the adequacy
of the system under current conditions based on tfre available information.
This report must be kept orti the premises with system�ocation artd pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner
� St�����/q,n�5 Qr2 -,-h� C9neS who Servi c.L }�is ro �� o�s
�� n - P �� �`�'P � �
Z C�1 � '� Co -��rnn ,
� , On the North Sbore of
Lake Minnetonka
ON-SITE SEWAGE TREATMENT
INSPECTION REPORT POST OFFICE BOX 66
� . � � 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357 S 5� �� _ �o�,f,h��
. r _7
OWNER �) 411 L--. .�►,.��a�5 ADDRESS ��C7C'� S{'laPa-f3° I� n� � �;J 2
PERMIT NO.'S. ��g� DATES � � �I ��� CONTRACTORS ��;.�Q
City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The on-site sewage
ueatment system at the above address has been inspected and appears to fall into the cetegory checked below.
(This is �an existing system ❑ new construction)
IC� � Meeu or exceeds current City standards in all respects relating to design,construction,and Iocation.,Appears to be operating
1��1 properly.
� 2 Dces 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 ereating 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,(Does not
� Pumpout not needed at this time.�c give accurate measurement of solids accumulation.) If tanks
❑ Solids aecumulation in ta�ks 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 es possible. � Orainfield is dry,no surfacing evident.
❑ System is discharging to surface. Tanks must be pumped ❑ Some eVidence of surfaci�g,not critical yet.
within 48 hours to elimi�ate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
❑ Inspection risera missing—tanks could not be inspected, effluent to the surface. This condition may require ceplace- '
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 exte�t and condition unknown.
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
p Lake,wettand,or stream ❑ High ❑ Inadequate
0 Drainage ❑System is causing visible •
surfAce discha�ge.
COMMENTS:��'l� 11i1 �P (''�52s' �f Qa! �T' �X A u/Y+T2 f�(i CC���a�s �T
4.'n 1;d s �n � �:-��. P[ease r�aQ,-, o� �� r�s.e r� c�,n� ha ue> ;t r,A —
` ` , no�
g- —g� : P�,out �►;5
Date of Inspection Septic Syst � e tor SVST�►! �/�%►�
/ i
Noie: 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 tNre available information.
This report must be kept ort�he premise5 with sysSem location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner