HomeMy WebLinkAbout05/04/18 Septic Compliance Inspection Minnesota Pollution Compliance Inspection Form
Control Agency p
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems
St.Paul,MN 55155-4194 (SSTS)
Doc Type:Compliance and Enforcement
Instructions: Inspection results based on Minnesota Pollution Control Agency(MPCA) For local tracking purposes:
requirements and attached forms-additional local requirements may also apply.
Submit completed form to Local Unit of Government(LUG)and system owner
within 15 days
System Status
System status on date(mm/dd/yyyy): 5/4/2018
® Compliant—Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3)
frame outlined in Local Ordinance.)
Reason(s)for noncompliance (check all applicable)
❑ Impact on Public Health(Compliance Component #1)-Imminent threat to public health and safety
❑ Other Compliance Conditions(Compliance Component#3)-Imminent threat to public health and safety
❑Tank Integrity(Compliance Component #2)-Failing to protect groundwater
❑ Other Compliance Conditions(Compliance Component#3)-Failing to protect groundwater
❑ Soil Separation (Compliance Component #4)-Failing to protect groundwater
0 Operating permit/monitoring plan requirements(Compliance Component #5)-Noncompliant
Property Information Parcel ID#or Sec/Twp/Range: 3311823430015
Property address: 175 Golden View Drive, Orono, MN Reason for inspection: Property Transfer
Property owner: Stephanie Rigley Owner's phone: 507-458-1753
or
Owner's representative: _ Representative phone:
Local regulatory authority: Cid of Orono Regulatory authority phone: 952-249-4600
Approximately 2-1000 gallon septic tanks,1-1000 gallon lift station and 630 square feet of mound
Brief system description: rockbed.
Comments or recommendations:
TBM: Top of lift station manhole cover
Certification
I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No
determination of future system performance has been nor can be made due to unknown conditions during system construction,
possible abuse of the system, inadequate maintenance, or future water usage.
Inspector name: Joseph J Olson - Certification number: 1255
Business name: Rusty Olson's Soil&Perc_Testipg _ License number: 810
Inspector signature:- Phone number: 763-498-8779
Necessary or Locally Required Attachments
® Soil boring logs ❑ System/As-built drawing ❑ Forms per local ordinance
❑Other information(list):
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwists4-31 • 1/24/12
Page 1 of 3
Property address: 175 Golden View Drive, Orono, MN Inspector initials/Date: J. 0.5/04/18
1. Impact on Public Health —Compliance component#1 of 5
Compliance criteria: Verification method(s):
System discharge sewage to the ❑Yes ® No ® Searched for surface outlet
ground surface. ® Searched for seeping in yard/backup in home
System discharge sewage to drain tile ❑Yes ® No 0 Excessive ponding in soil system/D-boxes
or surface waters. ❑ Homeowner testimony(See Comments/Explanation)
❑ "Black soil"above soil dispersal system
System cause sewage backup into ❑Yes ® No
dwelling or establishment. ❑ System requires"emergency"pumping
❑ Performed dye test
Any"yes"answer above indicates the system is ❑ Unable to verify(See Comments/Explanation)
an Imminent Threat to Public Health and Safety.
❑ Other methods not listed(See Comments/Explanation)
Comments/Explanation:
2. Tank Integrity—Compliance component#2 of 5
Compliance criteria: Verification method(s):
System consists of a seepage pit, ❑Yes ® No ® Probed tank(s)bottom
cesspool,drywell, or leaching pit. ® Examined construction records
Seepage pits meeting 7080.2550 may be ❑ Examined Tank Integrity Form(Attach)
co jpliant if allowed in local ordinance.
❑ Observed liquid level below operating depth
Sewage tank(s)leak below their ❑Yes ® No
designed operating depth. ❑ Examined empty(pumped)tanks(s)
If yes,which sewage tank(s) leaks: E1 Probed outside tank(s)for"black soil"
❑ Unable to verify(See Comments/Explanation)
Any "yes"answer above indicates the
system is Failing to Protect Groundwater. El Other methods not listed (See Comments/Explanation)
Comments/Explanation:
Peterson Company pumped the tanks.
3. Other Compliance Conditions—Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. ❑Yes* ®No ❑Unknown
b. Other issues(electrical hazards.etc.)to immediately and adversely impact public health or safety. ❑Yes* ®No ❑Unknown
*System is an imminent threat to public health and safety
Explain:
c. System is non-protective of ground water for other conditions as determined by inspector 0 Yes' ®No
*System is failing to protect groundwater
Explain:
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwists4-31 • 1124/12 Poge 2 of 3
Property address: 175 Golden View Drive, Orono, MN Inspector initials/Date: J. 0. 5/04/18
4. Soil Separation-Compliance component#4 of 5
Date of installation: 9/20/07 ® Unknown Verification method(s):
Shoreland/Wellhead protection/Food Beverage
Lodging? ❑Yes ® No Soil observation does not expire. Previous soil
observations by two independent parties are sufficient,
Compliance criteria:_ unless site conditions have been altered or local
requirements differ.
For systems built prior to April 1, 1996, and ❑Yes ❑ No
not located in Shoreland or Wellhead ® Conducted soil observation(s) (Attach boring logs)
Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs)
beverage or lodging establishment:
❑ Not applicable(Holding tank(s). no drainfield)
Drainfield has at least a two-foot vertical ❑ Unable to verify(See Comments/Explanation)
separation distance from periodically
saturated soil or bedrock. 0 Other(See Comments/Explanation)
Non-performance systems built April 1, ®Yes ❑ No Comments/Explanation:
1996, or later or for non-performance
systems located in Shoreland or Wellhead
Protection Areas or serving a food.
beverage, or lodging establishment:
Drainfield has a three-foot vertical
separation distance from periodically
saturated soil or bedrock.*
"Experimental", "Other", or "Performance" 0 Yes ❑ No Indicate depths of elevations
systems built under pre-2008 Rules; Type IV
or V systems built under 2008 Rules(7080. A. Bottom of distribution media 102.6
2350 or 7080.2400 (Advanced Inspector
License required) B. Periodically saturated soil/bedrock 99.8
Drainfield meets the designed vertical C. System separation 2.8
separation distance from periodically
saturated soil or bedrock.
D. Required compliance separation" 2.6
Any "no"answer above indicates the system is *May be reduced up to 15 percent if allowed by Local
Failing to Protect Groundwater. Ordinance.
5. Operating Permit and Nitrogen BMP*-Compliance component#5 of 5 ® Not applicable
Is the system operated under an Operating Permit? 0 Yes ❑No If"yes",A below is required
Is the system required to employ a Nitrogen BMP? ❑Yes 0 No If"yes", B below is required
BMP=Best Management Practice(s)specified in the system design
If the answer to both questions is "no", this section does not need to be completed.
Compliance criteria
a. Operating Permit number: _
Have the Operating Permit requirements been met? ❑Yes ❑ No
b. Is the required nitrogen BMP in place and properly functioning? ❑Yes ❑ No
Any "no"answer indicates Noncompliance.
Upgrade Requirements (Minn, Stat. §115.55)An imminent threat to public health and safety(ITPHS)must be upgraded.replaced,or its use
discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. If the system is failing to protect
ground water the system must be upgraded, replaced, or its use discontinued within the time required by local ordinance If an existing system
is not failing as defined in law,and has at least two feet of design soil separation. then the system need not be upgraded,repaired.replaced.or
its use discontinued.notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas.
Wellhead Protection Areas.or those used in connection with food,beverage. and lodging establishments as defined in law.
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwists4-31 • 1/24/12
Page 3 of 3
Date: May 4, 2018
Elmer J. Peterson Co.
5921 Dague Ave.
Delano,MN 55328
Phone 763-972-2420
Fax 763-972-7217
MPCA License# 219
Stephanie Rigley
175 Golden View Drive
Orono, MN 55356
507-458-1753
Baffles:( ON,/ OFF
Tank Capacity: 3-1000 Gallon Tanks
# of Tanks: 3
Type of Tanks: Concrete
Gallons Pumped: 2500
Manholes to Grade: ' YES / NO
Comments:
On May 4, 2018, Elmer J. Peterson Co. pumped septic tanks. No cracks or water leaking in tanks at that
time.
NOTE: This is only a tank report. This is not a compliance inspection for point of sale nor does it
replace a compliance inspection.
vyOlclil UIJL,Ic tyc•7T.,YYQy C.U.)USI LI 1 OJ LJ •'J
. _Around surface. ❑ Searched for seeping in yard/backup in home
System discharge sewage to drain tile ❑Yes ❑ No
❑ Excessive ponding in soil system/D-boxes
or surface waters. ❑ Hgmeowner testimony(See Comments/Explanation)
❑ "Black soil"above soil dispersal system
System cause sewage backup into 0 Yes ❑No 0 System requires"emergency"pumping
dwelling or establishment. ❑ Performed dye test
Any"yes"answer above indicates the system is 0 Unable to verify(See Comments/Explanation)
an Imminent Threat to Public Health and Safety. 0 Other methods not listed (See Comments/Explanation.)
Comments/Explanation:
2. Tank Integrity-Compliance component#2 of 5
Compliance criteria: Verification method(s):
System consists of a seepage pit, 0 Yes ® No 0 Probed tank(s)bottom
cesspool, drywell,or leaching pit. ❑ Examined construction records
Seepage pits meeting 7080.2550 may be ❑ Examined Tank Integrity Form(Attach)
compliant if allowed in local ordinance.
`—� 0 Observed liquid level below operating depth
Sewage tank(s)leak below their f ❑Yes ®No ® Examined empty(pumped)tanks(s)
designed operating depth.
If yes,which sewage tank(s)leaks:
0 Probed outside tank(s)for"black soil"
❑ Unable to verify
Any "yes"answer above indicates the (See Comments/Explanation)
system is Failing to Protect Groundwater. ❑Other methods not listed(See Comments/Explanation)
comments/Explanation:
On 5/4/18, Elmer J. Peterson Co. pumped tanks.
3. Other Compliance Conditions-Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. 0 Yes* 0 No ❑Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversely impact public health or safety. ❑Yes* ❑No 0 Unknown
*System is an imminent threat to public health and safety
Explain:
c. System is non-protective of ground water for other conditions as determined by inspector ❑Yes* 0 No
*System is failing to protect groundwater
Explain:
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in alternative formats
wq-wwists4.31 • 1/24/12 Page 2 of 3
Soil Observation Log
MN NN vers 12.1
Owner Information
Property Owner/project: Stephanie Rigley Date 5/4/2018
Property Address/PID: 175 Golden View Drive
Soil Survey Information ❑ refer to attached soil survey
Parent mat's: ❑Till E Outwash ❑ Lacustrine ❑Alluvium Li Organic ❑ Bedrock
landscape position: ❑Summit ❑Shoulder LI Side slope ❑Toe slope
soil survey map units: L32A slope °o direction- Lineal
Soil Log#1
0 Boring ❑ Pit Elevation 102.8 Depth to SIIWT 32 Inches
Depth(in) Texture fragment% matrix color redox color consistence grade shape
0-2 I Fill
21-32 Topsoi I <-35 l 0yr3'I Loose Moderate Blocky
32-42 Clay Loam <35 10yr4'3 I 0y4/8.1-6/1 Oy Firm Strong Blocky
loose loose
<35 single grain
friable weak granular blocky
35 -50
>50 firm moderate prismatic platy
rigid strong massive
loose loose
<35 single grain
35 -50 friable weak granular blocky
>50 firm moderate prismatic platy
rigid strong massive
Comments:
Si*, TESTING, INC. Steven B. Schirmers • MPGA cert.'0 6,27
951 Katydid Lane NE • St. Michael, MN 55376 '•-t7 3) 49 -
FAX • (763) 497-501
State License #394
LOGS OF SOIL BORINGS
Vintage Builders
175 Golden View Dr.
Orono, Henn. Co., MN
Borings completed on 8-25-05, with a hand bucket auger.
BORING NUMBER 3- Elev.100.0 - MOTTLED SOIL AT 16" - no standing water present
in boring.
0 - 10" Topsoil dark brown loam 2.5YR 3/2
10" - 16" Gray brown loam 2.5YR4/2
16" - 20" Rusty gray brown loam 2.5YR 5/2 mottles 10YR 6/8
20" - 24" Rusty gray brown clay loam 2.5YR 5/2 - mottles 10YR 7/1,6/8
BORING NUMBER 4- Elev.102.8 -through the mound.
0 - 18" Fill soil sandy loam
18" - 30" Fill soil medium sand
30" - 36 Original soil dark brown loam
BORING NUMBER 5- Elev.102.7 -through the mound.
0 - 8" Fill soil sandy loam
8" - 41" Fill soil medium sand
41" - 45" Original soil dark brown loam
P
S. TL S TING INC. Steven B. Schirmers • MP
951 Katydid Lane NE • St. Michael, MN 55376 •
t7fr3-)-497-3566
FAX • (763) 497-5-011------,
State
97-5 't--
State License#394
LOGS OF SOIL BORINGS
Vintage Builders
175 Goldenview Dr.
Orono, Henn. Co., MN
Borings completed on 1-12-04, with a hand bucket auger.
BORING NUMBER 1- - MOTTLED SOIL AT 18" - no standing water present in boring.
0 - 8" Topsoil dark brown loam 10YR 3/2
8" - 18" Yellowish brown clay loam 10YR 5/4
18" - 26" Rusty yellowish brown clay loam 10YR 5/6 - mottles 10YR 7/1,6/8
26" - 38" Rusty pale brown clay loam 10YR 6/3 -mottles 10YR 7/1,6/8
38" - 48" Rusty pale brown loam 10YR 6/3 - mottles 10YR 7/1,6/8
BORING NUMBER 2- MOTTLED SOIL AT 18" - no standing water present in the
boring.
0 - 10" Topsoil dark brown loam 10YR 3/2
10" - 18" Brown clay loam 10YR 4/3
18" - 26" Rusty brown clay loam 10YR 5/3 - mottles 10YR 7/1,6/8
26" - 32" Rusty pale brown clay loam 10YR 6/3 - mottles 10YR 7/1,6/8
32" - 36" Rusty gray clay loam 10YR 6/2 - mottles 10YR 7/1,6/8
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