HomeMy WebLinkAboutseptic info Rug,09 �,�8 �1 : l lp Rndy Kleindl [9521 -442-9281 p. 2
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�f � inn�sotaPoilution Compliance Inspection Form
ontrol Agency
0 Lafayette Road Norch Ex�sting Subsurface Sewage Treatment Systems (SSTS)
.Paul,MN 55155-4194 Instructions on page 7
Parcel num er: For Local Tracking Purposes:
System stat s: ❑Compliant ❑ Noncompliant
(based on a compliance requirements)
Summa Form
Propert Information
Property wner name(s): Dean Patterson ._. .. _.. ._
Property ddress: _ 2058 Shoreline Drive . _ _ .. .—
Property wners address(if different):
County: enne in Property owner phone: 612-328-1173 Permitting authority: .�r _ _
Date syst rn constructed: 1984 Reason for inspection: homeowner request
System escription
erief syst m description: ��� T�t��'S , I'�CK �.°✓�C��.S _......
Local pe it number: Number of bedrooms: 5 Design flow rate: .
Is the sy tem:
In Shor land area? �Yes ❑ No In Wellhead Protection Area? ❑Yes �No
An U.S Environmental Protection System serving a Minnesota Department
Agen (EPA)Class V Injection Well?0 Yes �(No of Heath(MDH) licensed faciliry? ❑Yes J�No
Complia Ce StdtUS(Based on state requirements–additional local requirements may also apply.)
Based on the information gathered and reported on attached forms,the compliance status of this system is(check one):
�Certifi te of Cornpliance–valid until(3 years from date of r�port):
❑ Noti of fVoncompliance-For Noncompliant systems:
Th reason for noncompliance is: � �—
Thi noncompliant system is classified as(check one below):
❑ minent threat to public health&safety ❑Failing to protect ground water ❑ Not in compliance with operating permit
C@ftiflC t10� (Completed form must be submitted to the local unit of governmerrt within 15 days.)
I hereby ertify that a!1 the necessary rnformation has been gathened to determine fhe compliance status oi this system. No
determin tion of future system performance hes been nor can be made due fo unknown condifions during system construcfion,
possible buse of the system,inadequate maintenance, o�future water usage.
Name: Andrew Kleindl ^ _ Certification number: 2926 .
Busines license name and number: Jim's Excavating, LLC . _ or
Name of local unit of govemrnent: — — • - -
Signatur : ,�������[�,.,_--� Date: Au9ust 9,2008
Require Attachments Inspector Complete: This Inspection Report is�pages long.
Check C mpliance fo�ms altached: �Hydraulic Performance �Tank lntegrity �oil Separation ❑Operating Pertnit Form(if
applica le) �System drawinglAs-built drawing ❑An assessment of any local requirernents that are different from what is required on this
forrn So Boring Logs ❑Abandonment form(if appropriate) ❑Other information(list);
Upg� dB RequlT2m 81115(de�ved from Mlnn. StaL§115,55J An lmminent threat to public health and safety(lTPHS)must be upgraded,replaced,or
its use iscond'nued within ten months ol receipt o/this noGce or wifhin a shorte�period if required by local ordinance.IT the syslem is failing to protect ground
water, e system must be upgraded,replaced,or its use disconUnued within the time requlred by foca!ordinance.!f an exlsting system is not tailing as de�ned rn
law,a has af least two feef of design soi/separaL'on.�hen the system need not be upgraded,repaired,replaced,or its use dlscontirtued,notwithstanding any
local o inance fhat is more sVict. This provision does not apply to systems in shoreJand areas,Wellhead Protec6on Areas,or those used in connecfion wifh lood,
bevera e,and lodging establishments as deh'ned in law.
. . ,. Compliance Inspection Form for Existing SSTS
Rug�08��8 fl1 : 12p Rndy Kleindl t952] -442-9281 p. 3
Parcel numb r: System status:�Compliant ❑ Noncampliant
(as determined by this form)
Hydrauli Performance and Other Compliance
Complia ce Issue #1 of 4
Oate of obs ation: _ — Reason for observation: _Q 1��ir' �.11�$� . __
This forrn ex ires upon next inspection or in three years,whichever occurs first: ._
Complian e questions/criteria: (Required) Verification Method*: (Optional)
Check he a ro riate box (Check the appropriate box)
Does the sy tem discharge sewage to the ❑Yes �'No �Searched for surface outlet
ground surf ce? — � Performed hydraulic test
Does the sy tem discharge sewage to drain ❑Yes �No � Searched for seeping in yard
tile or surfa watets?
Does the sy tem cause sewage backup ❑Yes �(No ❑ Checked for backup in home
into dwellin or establishment? .-- ❑ Excessive ponding in soil system/D-boxes
Do other sit ations exist that have the ❑Yes �,No ❑ Homeowner testimony
potential to i mediately and adversely
impact or th eaten public health or safety ❑ Examined for surging in tank
electrical, safe covers, etc.)? ❑ "8lack soil'above soil dispersal system
Any"yes" swer indicates that the system is an imminent � System requires"emergency"pumping
threat ta pu lic health and safety.
___ _ — — ❑ PerFormed dye test
Does the sy tem pose a threat to ground ❑Yes �[No � Other: __. _ .—
water for an conditions deemed non-
rp otective a determined b the ins ectoi'? —
"Yes"Indi ates that the sysiem is failing to proteci . —
ground wa er.If"yes';describe!he condition noted: •�o standard profocol exists. This list is not exhaustive,
in sequentia!order, nor does it indicate which
combinations are necessary to make this determination.
Certific tion
This form i to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency's(MPCA) Compliance
fnspection Form for Existing SubsurFace Sewage Treatrnent Systems.Observations, interpretations, and conclusions must be
completed y an inspector. Completed form must be submitted to the local unit of government within 15 days.
Property o ner name(s): _Dean Patterson _ �--- -�-�
Property a dress: 2058 Shoreline Drive _ — ----—
Property o ners address(if different):
County, Henne in Phone: 612-328-1173 _._ _..__
1 hereby c ify tha[!personally made the observations, interpretadons, and conclusions reported on this form and that they are
correct.
Name: ndrew Kleindl Certification number: 2926 _
— or
Business li ense name and number: Jim's Excavatinq LLC ---
Name of lo I unit of government: �,,��i----
Date: _���.^�V�—,--.—_
Signature:
_ . Cornpliance Inspection Form for Existing SSTS
Rug�08 ,48 Ul : lZp Rndy Kleindl (9521 -442-9281 p. 4
Parcel numb r: System status: �Compliant ❑ Noncompliant
(as detem►ined by this form)
Tank In grity and Safety Compliance
Complia ce 15sue #2 of 4
Date of obs rvation: _ � �O Reason for observation: Q'GJ Yl� ���� . _.. ..—
This form e ires on (three years): —
Complian e questionslcriteria: (Required) Verification Method*": (Optional)
_ Check he appropriate box (Check the appropriafe box)
Does the sy tem consist of a seepage pit', ❑Yes �No ❑ Probed tank bottom
cess�ool,d ell,or leaching pit? _ ❑ Observed low liquid level
Do any sew ge tank(s) leak below their ❑Yes (�No
desi ned o ratin de th? ❑ Examined construction records
If yes, identi which sewage �'�amined empty(pumped)tank
tank leaks. •- ❑ Probed outside tank for"black soil"
Any"yes"a swer indicates thaf the system is failing to protecf � pressure/vacuum check
ground wat r.
❑ Other:
' Seepage its meeting 7080.2550 may be compliant if allowed
in ordina e by local pennitting authority.
"No standard protocol exists. Thrs/ist is not exhaustive,in
sequentia!order, nor does it indicafe whlch combinations
are necessary to make this determination.
Safety C eck
1. Are an maintenance hole covers damaged, cracked, or appeared ta be structura{ly unsound? ❑ Yes" �No
2. Were a I maintenance hole covers replaced in a secured manner(e.g.,all screws replaced)? (�Yes ❑ No'
3. Was s ondary access restraint present(safety pan,second cover, or safety netting)—highly recommended. ❑Yes �No
4. Was a y other safety/health issue present? ❑Yes' (�No
Explain ___ �. — - —
*Syste is an imminent threat fo public hea/th and safeiy.
Certific tion
This form i to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency's(MPCA)Compliance
Inspection Form for Existing Subsurface Sewage Treatrnent Systems. Observations,interpretations,and conGusions must be
completed y an inspector, maintainer, or service provider.Completed form must be submitted to the local unit of govemment within
15 days.
Property o ner narne(s): Dean Patterson _ _— — —� —� --
Property a dress: 2058 Shoreline Drive __— -•— �— — �— —�-
Property o ners address(ifdifferent): — --
County, Hennepin Phone: 612-328-1173 _ —
I hereby c ify fhat!personally made the observatrons,interpretations, and conc/usions repo�ted on this form and that they ane
correcf.
Name: ndrew Kleindl CeRification number: 2926 . _
Business li ense name and number: Jim's Excavatin , LLC _� __ _.._ or
Name of I I unit of govemment: '—
Signature: Date: ���_. _
,.,,,_��r -3� Comptiance Inspection Form forExistrng SSTS
Rug�09 ��8 01 : 13p Rndy Kleindl [9521 -442-9281 p. 5
. •
Parcel num r: System status: �]Compliant ❑ Noncompliant
(as determined by this form)
Soil Sep ration Compliance and Other Compiiance
Complia ce Issue #3 of 4
Date of obs rvation: �Q�_ Reason for observation: Q��y►�ji' y`�1,��
This informa ion on fhis form does nof expire.
Complian e questionslcriteria: (Requi�ed) Verification Method": (optional)
Check th a ro riate box (Check the appropriate box)
For systems built prior to April 1, 1996,and not �Conducted soil observation(s) (attach boring logs)
located in S oreland or Wellhead Protection
Area or not erving a food, beverage or ❑ Two previous verifications(aitach boring lags)
lodging esta lishment: ❑ Other:
Does the sy tem have at least a two-foot �
vertical sep ration distance from periodically
saturated so I or bedrock? ❑Yes ❑ No _.___
For non-pe rmance systems built April 1, _
1996,or late or for non-performance systems Soil observation does not expire. Previous observations
located in S oreland or Wellhead Protection by two independent parties are sufficient, unless site
Areas or se ing a food, beverage or lodging conditions have been altered.
establishme t:
Does the sy tem have a three-foot vertical �
separation d stance from periodically saturated
soil or bedro k?' Yes ❑ No
For reduced separation distance systems (i.e.,
"performanc "systems unde�old 7080.0179 or " May be reduced by up to 15 percenf if allowed in/oca!
Type IV or system under new 7080.2350 or orrlinance.
7080.2400): ••No standard protocol exists. This list is nof exhaus6ve,
Does the sy em meet the designed vertical in sequential order, nor does if indicafe which
separation d stance from periodically saturated combinations a�necessary to make this
soil or bedro k?' ❑Yes ❑ No determination.
Any"no"an wer indicates that the sysfem is failing fo protect
ground wa
Certifica ion
This form is o be completed and attached to the Summary Form of the Minnesota Pollution Control Agency's(MPCA)Compliance
Inspection orm for Existing Subsurface Sewage Treatment Systems. Observations,interpretations, and conclusions must be
completed b an inspector or designer. Completed form must be submitted to the local unit of govemment within 15 days.
Properry ow er name(s): Dean Patterson .. __ ..... ..
Property ad ress: 2058 Shoreline Orive _ , ... .._
Property ow ers address(if different): _
Counry: enne in Phone: 612-328-1173
I hereby ce 'fy that!personalfy made the observafions, interpretations, and conclusions�ported an this form and that they are
correct.
Name: A drew Kleindl Certification number: 2926 .
Business lic nse name and number: Jim's Excavatinq, LLC __ or
Name of loc I unit of government: —
Signature: Date: ���d� _ ,.
wq-wwists4- 1 Comp(iance lnspection Form for Existing SSTS
Rug. 09,�,�8 �1 : 13p Rndy K 1 e i nd 1 (9521 -442-9281 p. 6
,
,
Site Sketch:
--- ---� � i ��I— i�i..___..� � ;_.-__ �.--J�.--i___,.
_.__�,;;- i...�l_.._t=!_._�!_�-1___._.!___.I��i�!-1 1._ '
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. � 1 I I�!�!���� E �..���--
i L i I� 1 1 I �_; �E�l____��_�.
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_ ���_���� ��—I��.__._� .�—.._�_.__,..__ �i a ,00�
f� i i
p Mse indicate the location of Well,well setback to system,dwelling or other establisFimeM,tank(s),soil treaanent system,
r rved soil trcatrnent area,curtain drain,Property lines,watenvays,and buried lines(those NOT installed by the utility).
I cluda sius and Iength and appc�ximate distanccs from Fxed referencc points such as streets snd buitdings. Please attach as-
b il[drawings,irtspocuon reporls,Certificatc(s)of Compiiance snd Notice(s)of Non�mpliance,if availablc.
Soil orings(BR#): Locate each boring on the map above,indicate on the right of the colurnn the soil
textu e,structure,color,depth of each different soil type,evidence of mottling,bedrock and standing water.
Atso ndicate if the material is fill.
BR# BR# BR# BR# BR# BR#
i
a��r�3 �
� �^ '
n � . , -
RECORD D OF MOTTLING,SFASONAL FIIGH WATER(AS D&TERMINED USING THE MLMSELL COLOR BOOK)aR BEDROCK ON
ABOVE LIN
CQ�
Commcna: l�'I�YUvev� be�l
� r� d j � �.
What needs t be completacl to bring ihe above system into compliance if found not in wmpliance?
_-o`�� �
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Y � '��'` CITY of ORONO
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,� ,;,, , r�,.. �, : . �
v�,, �;� ;�y. ;;; ,. �lS� Municipal Offices �
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� `;' '+`<`��.``} �' Street Address: �15a-a4q—ybo � Mailing Address:
'9kEgKp4'� 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystai Bay, MN 55323-0066
To Current Owner: Address: �U S� S �`�r t�i�n�: ��
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.
SYSTEM CONFORMITY 1-3 : �
1 "CODE SYS`TEM" An ISTS which meets all the location,design and construction standards of the current Orono Municipal Code.
2 "COMPLIANT SYSTEM" An ISTS which does not meet all the tocation,design and construction standards of the current Orono
Municipal Code but does meet the three foot separation requirement or two foot requiremcnt for systems installed 1996 or eulier,and
which is not failing or an imminent threat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a designated 100-year flood plain,any ISTS which may
or may not meet all the location,design,or construction stan�ards of the current Orono Municipal Code and which is failing for any
reason;and any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil chuacteristics.
�
TANK CONDITION(5-71: 5
Tank inspection indicates:
�Pumpout not needed at this time.
6 Septic tanks must be pumped out this year (city code recommends tanks to be pumped out once every 3 years.
Tank was last pumped a i`1-r�3 ).
Make sure septic tanks are pumped throush manhole and not through white inspection pipes. This allows for the proper
cleanin¢. Keep water softner and iron filter dischar¢e out of septic svstem to prolon¢life of drainfield. Ask aumper to test
alarm float to verifv alarm is still workine in vour house. The alarm warns owner that seatase is about to backua into basement.
7 Inspection risers missing-tanlcs could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank. If
tanks have not been pumped out within the last three years,they should be pumped out now.
DRAINFIELD CONDITION 8-10 : �
8 Drainfield is dry,no surfacing evident.
9 Some evidence of surfacing,not critical yet.
10 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
r�._� �-��� a-- S t �-.z. ���5 �o o�C 0 ��
COMMENTS: UJ �- � I
��'Zq—b Ll u �,,�-,
Date of Inspection Matt Bolterman - Septic System Inspector
Not�: In the event that this inspection report is used to satisf} the requirements for a mortgage or other transfer oFpropcm. be advised that this repur�does
IWl ��U:lCAl1l2G OI' Cl'f11r\' tll8l an e�is'�in2 s�•stem ���ill continue tu f�unction properl�•. but is mereh� an opinion of the adequac}� oF the s��stem un�ler currrni
wn�itiuns based on the avail161c inConnation.
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'Z '''r•�:;�` �' ' Street Address: �
��H�g 2750 Kelley Padcway MailinQ Address:
� Orono, MN 55356� � P•�• Bax 66
• gSa-�4q—y600 � Crystal Bay, M�Y 55323•006
To Cu.-rent Owner: Address: ab�� .s�d(e �;r>e ��
City Ordinance 199 requires that each existin�on-site sewage treatment system in Orono be inspected every two years.
The on-site sewa�e treatment system at the above address has been inspected and appeazs to fall into the categories checked below.
SYSTEM CONFOR1�tITY (1-31: 1
� "CODE SYSTEM"An ISTS which mcecs all the location.duign and constructioa standards of the current Orano htunicipal Cade,
"CO�LIANT SYSTEM" An ISTS which does not meet all the location.daign and cocuuuction standards of the cucrent Ororto hfunicipal
Code but dou meet the t}uee foot separation nquiremeot or two foot requirtment for rystems installed 1496 or earlier,and which Is n�t failing or
.an imminent threat to public health orsafery.
3 "NON-COyIPLIANT SYSTEM" A prohibited iSTS;an ISTS located within a duignatcd 100-ycar flood plain,any JSTS which may
or may not meet alt the location,design,or constru�don standards of�e cumnt Orono Munictpal Code and which is failing for anY teason;and
any ISTS with leu than three fcet of unsaturaced soil or sand becwcen the disDibution device and the limitina soil charactecistiu.
TANK COWITION(5:7):
Tanl:inspection indicates: � . '
5 Pumpout not needed at this time.
6O Septic tanks must be pum ed out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumptd�o i �, .
hlake sure septic tanks are pumped throuQh manhole and not throuQh white insoection otpes
This alloti3s for the proper cleantn?.
7 Inspection risers missin�tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
D INFIELD CONDITION -!Q ; �
8 Drainfield is dry,no surfacing evident.
9 Some evidznce of surfacin„not critical yeG •
10 Drainfield is saturated and visibly dischargin�uncreaced effluent to the surface. Contact the Ciry Inspector
immediatety.Repairs must be eomp(eted within 90 days.
COM�fENTS: q.��:c.11� �oa�S Q�._ P�� S� 1-�c_ �� S,
�-\1 -4� �J Y��
Date of Inspection I�iatt Boiterman- Se tic S em I
P � yst nsptcto�
Note: in the event that�4is uupecdon repart is tued W suisfy the cequiremenes Cor a moctoage orathertransfer ofprope .ry�be advised that this nFort doa notgu=n���
orce;tify thu an eristino rystem will contin�e to funcdon properly,but is mereiy an opinion ofthe u'equary of the systcm under earnnt condidons based on the avzil�bl
infomwtion.
� O�
..
,:�,` O .
���� CITYof ORONO
� ���°�'�• ..t`..'�, s,►
`L• y;•�.
� ;.�;p,�#}�.'.�;;� Gti� 14iunIcipaI ofiices -
� ��''�` i"' t���y Street Address: .
��'�,;��g Maiifng Address:
2750 Kelley Parkway P.O. Bax 66
Orono, MN 55356 Crystal Bay, MN 55323•006b
. 95d=�4q-y600
To Current Owner: Address: ab S 4� S�o r e I;n e. [��'.
Ciry Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every two yeazs.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYST'EM CONFORMI'IY 1-3 : �
1 'CODE SYSTEM"An ISTS which meets al!the location,daign and conswction standards of the current Orono Munictpal Code.
2 "CO�LIANT SYST'EM" An ISTS which does not meet all the location,design and construction standards of the eurrertt Orono Municipa!
Code but does meet the ttuee foot separation requirement or two foot rcquirement for sysums ir�talled 1996 oc earlier.and which is not failing or
an imminent threat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited iSTS;an ISTS located within a designated l00-year flood plain.any ISTS which may
or may not meet all the location,design,or construcdon standards of tj�e cnrcent Orono Municipal Code and which is failing for any rcason;and
any ISTS with leu than tluee feet of unsaturated soil or sand between the d'utribution device and the limiting soi]eharacteristia.
TANK CONDITION(_5-:71: � �
Tank inspection indicates: .
SO 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 years.
Tank was last pumpad_ b-1-D 1 � �
l�iake sure seatic tanks are numned through manhole and not through�r•hite ins�ection oines
This allo�+s for the oraoer cleaning.
7 Inspection risers missina tanks couId not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
INFIELD CONDITION -1Q :
8 Drainfield is dry,no surfacing evident.
9 Same evidence of surfacing,not critical yet. �
10 Drainfield is saturated and visibly dischazging untreated effluent to the surface. Contact the Ciry Inspector
immediately.Repairs must be completed within 90 days.
COVIi1�NTS: Q �a;��.e�c� a„� Sep+�,z ��nkS � o�� vK
I o -�--oa �cczc
Date of Inspection Matt Belterman— Septic System Inspector
Note: in the event that this inspecdoa rcport is used to satisfy the rcquirements for a mortgage or other transfer of properry.be advised that this report does aot guarantee
arcertify thaz an existing rystem will continue to funcdon properly.but is merely an opinion ofthe adequary of the system under eurrent condidons based on the availabte
information.
� °�
, o . o
' -� ��� CITY of ORONO
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I I�, a A'���'��i� ,y .
,,� } �:- ��� ,�ti Municipsl Ot�ices
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? <g� Street Addroaa: Mailin�Addreu:
ygHO 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
July 24, 2000
Katherine Norman
2058 Shoreline Drive
Wayzata, Mn 55391
Dear Nlrs. Norman:
An inspection of your septic system was conducted on June 29, 2000. A summary of the inspection
is beiow.
Se�tic Tank Condition
1. Pumpout needed within one year. (last pumpout date 6/10/98)
The septic system is a compliant system, meaning it meets all or most cunent 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 maintenance in the future.
Also enclosed is a fact sheet explaining 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 pectfu ,
. �� /
GKi�
Chris Pence
On-Site Systems Manager
Enclosures
In the e�ent this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,
be ad�lsed that this report does no guarantee or certify the eaisting system Rzll 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
May-29-98 07 : 44A ROBERT NARE BurnetRealty 612-476-5418 P . 02
DN �ccan►atina ��81,NYA,ARN,55397
May 28, 1999
Robert Hare
2E)1 Lake Street
Wayz�ata, MN
55399
Dear Robert:
The System for Mita at 205� Shareline Dfive Y►z�d a blockage in the outlet pipe between the tank�tnd
the distribution bvx The problem was cured by augering the line dear of the clog. T1�ere appeared to
be a bwldup ot the scum layer at the outl@t opening. This was made up qf h8if and other flOaliflg
materials We dp npt reCpmmend flushing d1e system with large qudnt�ties of water at one time. This
system i'�as � 720 square feei of drain field ared. 111is sy�tem should corttinue t0 be adequate for
drtposal of!he w�tewster generated in the home, if the system is maintained. 'The tanks had iittle
sludge b�rikl up. Finally, the soi�s are very sandy in the area oP the drain field area wt�ich is conducive to
the woricing of the system. I did not perform a comphance inspectian on this propeRy, but did do repair
in the clean pi 1he pipe. The other information in this letter is my oC�servatians wr,ile�t the s�te. Please
cati me ir you have any questia�s. i w��l be avaa�ab�e after June 1, 1998. An in�pice will be forthcoming
for services reridered in the amount of$150.
Sincerely,
Dave Hormann
Partner of DH Exaavating
MRCA Ucense�1644
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�����-� CITY of ORONO
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�'„ �� :}��"'"' ,�14 Municipal Offices
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'� ' Street Address: Mailin� Address:
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�9$EgK04'� 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
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Owner: � Address: 205@ Shoraline Dr.
Permit #'s: 6351 Dates: 6/22/81 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.
(Tha saturated soil leval [�j has or [ ] has aot been ideatified at this time. If the
saturated soil leval has not been identified, this clasaificatioa is subject to revision.)
K CONDITION (5-9) : 5
S 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.
(During the last saptic tank Maintenance Pu�out the tanks [ ] wera or [�] ware not confirmed
to be watertiQht by tha licensed pua4pin� contractor. If the tanks were not coafirmed to ba
watertiQht, this classificatioa is subject to revisioa.)
D INFIELD CONDITION (11-14) : 11
Drainfield is dry, no surfacing evident.
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.) : medium
COMMENTS:
1� �I°l7
Date of Inspection S tic 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
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,� ����=� CITY of ORONO
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�� � .�G Street Address: Mailing Address:
'`�'�gg0g' �� ���� 2150 Kelley Parkway P.O. Box 66
�— /-' Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: Address: 2058 Shoraliae Dr.
Permit #'s: 6351 Dates: 6/22/81 Contractors: Widmer Bros.
(This is [/\j an existing system [ ] new construction) .
✓ �
SYSTEM COMPLIANCE (1-3) : 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 ideati£ied at this time. If the
saturated soil level has aot beea identified, this classffication is subject to revision.)
K 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.
(Duriny the last septic tank Maiatanance Pua�out the taaks [ ] were or � ware not con£irmed
to be watertight by the liceased pua4pinQ coatractor. If the taaks mera not coafirmed to be
watertight, this classification is subject to revision.) .
D INFIELD CONDITION (11-14) : 11
Drainfield is dry, no surfacing evident.
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.) : . medium
COMMENTS:
��
Date of Inspe ion S tic 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�
M�icipal Offices O O
Post Office eox 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWA(�8 TREATN�IT
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INSPECTION REPORT
�9kESHo�'�
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Owner: Address: r
Permit �'s: Dates: Tl��'"�' Contractora:����1�� .
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)
SYSTEM 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 which
is operating setisfactority 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 �y 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 ihe lim�ting sotl characteristics.
(The 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 t5-10):
Tank inspection indicates:
5 Pumpout 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 punped out as soon as possible.
8 System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface dischar�e.
9 lnspection 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 punped out within the last three years, they should be pu�ped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accunuletion).
_ If tanks have not been punped out within the last three vears, thev should be punped out now.
DRAINFIELD CONDITION C11-14):
DPSirfield inspection indicates:
VY Drainfield is dry, no surfacing evident.
T2 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 Orainfield extent and condition unknown.
LIMITING SITE FACTORS Csloce,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (deaends on soils.water table.etc.): ��� �
CO NTS:< �
l �rl;
Date of Inspection Se 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 cert�fy that an existing system will continue to tunction
propertyi but is merely an opim on of the adequacy of the system under current corxiitions based on the avaitable
information.
This report must be kept on the pre�nises with the system locstion and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner