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Minnesota Pollution Compliance Inspection Form
Cantrol Agency � � �isting Subsurfacs Sewags Trsatmsnt Systems
520 Lafayette Road North ��TS�
5�Paul,MN 55755-4194
Doc Type:Compliance and EnforGement
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 Govemment(LUG)and system owner
within 15 days
System Status
System status on date(mmlddlyyyy):
❑ 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 Orrlinance.)
Reason(s)for noncompliance(check all applicab/e)
❑ Impact on Public Health (Compliance Componenf #1)–Imminent threat to public health and safety
❑Other Compliance Conditions(Compliance Component#3)–Imminent threat to public health and safety
❑Tank Integrity(Compliance Componenf #2)–Failing to protecf groundwafer
❑Other Compliance Conditions(Compliance Component#3)–Failing to p►r�tect grr�undwater
❑Soil Separation(Compliance Component #4)–Failing to protect groundwafer
❑Operating permiUmonitoring plan requirements(Compliance Component #5)–Noncompliant
Property Information Parcel ID#or Sec/Twp/Range:
Property address: Reason for inspection:
Property owner: Owner's phone:
or
Owner's representative: Representative phone:
Local regulatory authority: Regulatory authority phone:
Brief system description:
Comments or recommendations:
Certification
1 hereby certify that all the necessary infom►ation 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 condifions during system construcfion,
possible abuse of the system, inadequate maintenance, or futur�water usage.
Inspector name: Certification number:
Business name: License number.
Inspector signature: Phone number: fi
Necessary or Localty 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 • Avaitable in altemative formats
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' Property address: Inspector initials/Date:
1. Impact on Public Health—Compliance component#1 of 5
Com liance criteria: _ Veri�cation method�s):
System discharge sewage to the ❑Yes ❑No ❑ Searched for surface outlet
round surface. ❑ Searched for seeping in yard/badcup in home
❑ Excessive ponding in soil system/D-boxes
System discharge sewage to drain tile ❑Yes ❑No � Homeowner testimony(See CommentsiExplanation)
or surface waters.
❑ "Black soil"above soil dispersa)system
System cause sewage backup into ❑Yes ❑ No � System requires"emergency"pumping
dwelling or establishment. ❑ PerFormed dye test
Any"yes"answer above indicates the system is ❑ Unable to veriTy(See Comments/Explanation)
an lmminent Threat to Public Health and Safety. ❑ Other methods not listed(See Comments/Explanation)
Com ments/Explanation:
2. Ta11k Integ�ity—Compliance component#2 of 5
Com liance 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)
com liant if aUowed in loca!ordinance.
❑ Observed liquid level below operating depth
Sewage tank(s)leak below their ❑Yes ❑No � Examined empty(pumped)tanks(s)
desi ned o eratin de th.
❑ Probed outside tank(s)for"black soil"
If yes,which sewage tank(s)leaks: �
_ ❑ Unable to venfy(See Comments/Explanation)
Any"yes"answer above indicates the ❑Other methods not listed(See Comments/Explanation)
system is Failing to Protect Groundwater.
Com ments/Explanation:
3. Othe�COmplldnCe Conditio115—Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to strudurally unsound. ❑Yes* ❑No ❑Unknown
b. Other issues(electrical hazards,etc.)to immediately and adversey impact public heafth or safery. ❑Yes* ❑No ❑unknovm
'`System is an imminenf threat to public health and safety
Explain:
c. System is non-protective of ground water fo�other conditions as determined by inspector ❑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 • 1/24/12 Page 2 of 3
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, Inspector initials/Date:
Property address:
4. Soil Sepa�dtion—Compliance component#4 of 5
Date of installation: ❑ Unknown Ver�cation method(s):
ShorelandNVellhead protectioNFood Beverage �Yes ❑No 3oi1 obse►vation does not expire. Previous soil
�odging7 observations 6y two independent padies aie sufficient,
Com liance c�iteria: _ _ _ unless site conditions have been altered or local
requirements differ.
For systems built prior to April 1, 1996,and ❑Yes ❑ N� � �onducted soil observation(s)(Attach boring logs)
not located in Shoreland or Wellhead
Prntec6on Area or not serving a food, ❑ Two previous veriflcations(Attach bonng 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/Expianation)
separation distance from periodically ❑ Other(See Comments/F�cplanation)
saturated soil or bedrock.
Non-perfom►ance systems built Apri11, ❑Yes ❑No Comments/Explanation:
1996, or later or for non performance
systems located in Shoreland orWellhead
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" ❑Yes ❑ No IndiCate de ths of elev8tions
systems built under pre-2008 Rules;Type IV A. Bottom of distribution media
or V sysfems built under 2008 Rules(7080.
2350 or 7080.2400 (Advanced Inspector
License required) B. Periodicall saturated soiUbedrock
Drainfield meets the designed vertical C. S stem se aration
separation distance from periodically
saturated soil Or bedrock. D. Re uired com liance se aration�
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*—comp�iance component#5 of 5 ❑ Not applicable
Is the system operated under an Operating Permit? ❑Yes ❑ No If"yes",A below is required
Is the system required to employ a Nitrogen BMP? ❑Yes ❑No If"yes",B below is required
BMP=6est Management Pracfice(s)specified in the system design
!f the answer to both questions is "no", this section does not need to be comp/eted.
Com liance criteria
a. Operating Permit number: ❑Yes ❑No
Have the O eratin Permit re uirements been met?
b. Is the re uired nitro en BMP in lace and ro rl functionin ? ❑Yes ❑ No
Any "no"answer indicates Noncompliance.
Upgrade Requtrements(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 ordinence.If the system is failing to protect
ground water,the system must be upgraded,replaced,or its use discontinued within the time required 6y 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 dlscontinued,notwithstanding any local ordinance that is more strict. This prov/sion does not apply to systems!n shaeland areas,
We/lhead Protection Areas,or those used in connection with fo0d,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 altemati�Qge 3 of 3
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Site Sketch:
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Suggested items for site sketch: Wdl,well setback to rystem,dwelling or other establishmcnt,tank(s),soil treatment system,
reserved soil treatmcnt area,cuRain drain,property lines,watenvays,and bucied lines (those NOT installed by the utility).
Include sizes and length and app�oximate distances from fixed reference poinu such as streeu and buildings.�Please attach
previous as-built drawings,inspection reports,Certificate(s)of Compliance and Notice(s)of Noncomptianee.
Soil Boriugs (SB #): Locate each boring on the map above, indicate on the right of the columns
�low the texture, structure,color, depth of each different soil type,evidence of mottling,bedrock and
.�nding water. Also indicate if the material is fill.
SB # SB# SB #
Comments:
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�'` � ��'� CITY of Oli4N0
i,�l r�! ,`, � `�` "�"l�i Municipal Offices
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��` '� '�, ' �;�'• G Street Address: Mailing Address:
l � ' '� P.O. Bax 66
*,�kE$H�4: 2750 Kelley Parkway
- - Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Current Owner of Address ���,5� .�� 1 c!�!cl:��i.�!
City Ordinance requires that onsite sewage treatment systems in Orono be
inspected on a periodic basis. The onsite sewage treatment systern at the above
address has been inspected and the following is known about the system. A
sketch of the known components of the system is available for most properties at
the Orono City Hall.
Imminent Public Health Threat
Yes �No
If yes,please contact the Onsite Systems Manager at 952-249-4626 within 1Q
days of receipt of this notice. The septic system must be brought into compliance
within 90 days. Failure to do so will result in referral to the City Attorney for
legal action.
System Identi�ed as Non-Compliant
Yes �No
If yes, system must be brought into compliance by:
December 31,2007
December 31,2010
Other
Septic Tank(s Pump out Needed
Yes
No
The City recommends the septic tank(s) and/or lift tank be serviced and pumped
out every three years. City records indicate the tank(s) were last pumped out on
o � _ � � - � g . The tank(s) should be cleaned through the manhole and
not through the inspection pipes,this allows for proper cleaning.
Comments:
.�.
Inspector:
. Date of Inspection ��-`v -�
Telephone(952)249-4600 � Fax(952)249-4616
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�',t � +,.,}���.��,,�' G Street Address: Mailin�Addresa:
'!$�p�"� 2750 Kelley Parkway P.O. Box 66
�ono, MN 55356 Crystal Bay, MN 55323-0066
To Current Owner: Address: �O 6 7S S '�V��v'e`� �C'
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.
YSTEM CONFORMMT'Y 1-3 : �
1 "CODE SYSTEM"An ISTS which meets ali the location,design and con�truction standards of tfie current Orono Municipai Code.
2 "COMPLIANT SYSTEM" An ISTS which does oot meet all the locetion,design and construction standards of the curnni Oro�Municipal
Code but does meet ffie tkuee foot�paration requirement or two foot requirement for systems installed 1996 or earlier,snd which is not failing or
sn imminent ffireat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;�ISTS located within a de.cignated 100-year 800d plain,any ISTS which may
or may not meet all the location,design,or construcxion standards of the cursent Orono Municipal Code and which is failing for any reason;snd
any ISTS with less than three feet of unsaturated soil or sand between the distribution device and the limiting soil characteristics.
TANK CONDITTON(5-7): �
Tank inspection indicates:
��. Pumpout not needed at this time.
USeptic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped
Make sure seatic tanks are pumned t6rough manhole and not through white inspectioa uipes. This allows for the
proger cleanine. Keep water softner and iron filter dischar¢e out of seatic svstem.
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank. If
tanks have not been pumped out within�e last three years,they should be pumped out now.
INFIELD CONDITION(8-10): �
Drainfield is dry,no surfacing evident.
9 Some evidence of surfacing,not critical yet.
10 Drainfield is saturated and visibiy discharging untreated ePfluent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
COMMENTS: pc�:�-x,1t� �oa� b� �_ e�e�ir:�- bbx_ P u�- S }�
��L-5 .� � �v� �o fi- 6c�� u� �, '� \'�S
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Date of Inspection Matt Bolte�man- Septic System Insp�tot
No�e: In the event that this iospedion roport is used oo satisfy the requirements for a mortgage ar other trms�r of property,be advised tl�at this n�nt docs aot guerantee
�ce�tigy d��exis�ing sysbem will contin�to fi+nction propaiy,but is merely�opinion ofthe a�quacy of the sysbem under cxurent conditions based on Uu available
inEamation.
1lelephone(9S2)1A9-+600 • Faz(952)?A9-�616
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����.;,��{!��-'�'y Street Addrou: Maiiln�Addross:
Og 2750 Keiley Pa�kway P.O. Box 66
Orona, MN 55356 Crystai Bay, MN 55323-0066
Owner: Pe�te!' V'ac�0 V2('�X'.ke Address: oZ675 S:Ive� V;e,,,. Q�'.
Ciri•Ordinance 199 requires that each existing on-site sewage treatment system in Orono be inspected every nvo years.
The on-site se�vage treatment system at the above address has been inspected and appears to fall into the categories checked belo�v.
SYSTEM CONFOR1�fI'TTY (1-3): I
� "CODE SYSTEM" An ISTS wluch meets aI!the tocatioq design and constcuction standards of t!u aurent Ocono Municipai Coda
2 "COMPLIANT SYSTEM" An ISTS which does not meet ali the(ocatioq desig�aad coastcuction staadards of the cun rnt pi,ono Municipal
Code but does rcuet the three foot separatioa nquirement,and which is aot failing or an imminent throat to public health or safety.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a daigiated 100-year IIood plain,any ISTS which may
or may not med att the location,daigq or coastructioa standards of the cutrent prono�funicipat Code and wl�ich is failing for any reuon;and
any ISTS with las t(�aa three feet of unsaturated suil or sand between the distribution device and ihe limitiag soil characteristics,
T.4MC CONDITION(5-10): C�
T�nk inspection indicates: �
� Puinpout uot needed at this time,
6� Tank must be pumped out this year (ciry code requires tantcs to be pumped out evay 3 years. Tank was last pumPed I�-1.�' q a ).
7 Solids accumu(ation in tanks is at a aitical a critica!IeveL Tanks should be pumped out u sooa a4 pe�ssibla.
$ System is discharging to the surface. Tanks must be pumped out within 48 hours W eliminate surface discharge.
9 Inspection risers missing-tanks eeuld not be inspected, Inspection risecs(4"dia piQe)must be installed in esch tanlc at next pumpout If tanks
have not bern pumped out within the(asc three yeats,they should be pumped out now.
10 Inspection pipe is(ocated directly over tank bagle(does not give accurate measurcmrnt of solids accumulation). If tanks have not becn pumped
ouc within the(ast tl�ree yeus,they should be pumped out now.
D IELD CONDTTION 11-1=1 : �_
11 Ikainf eld is dry,no surfacing evident
12 Some evidence of surfacing,not critical yet
13 Drainfield is satutated and visibly discharging u�reaced e@lurnt to the surface. Co�rtact the City Inspector immediately.Repain must be
completad within 90 days. �
1� Draintield e:etrnt and condition unknowa �
CO1�Il�IENTS: 5 S��. l oakS 0 - F' elec,�r'
bo,c o� ��. t�+�k . P��
h�c►.��(S '.� '�1.e,r 1.qvc. �.o�c- 5ce�. � ��n.Ae �,r,; :� 1aS�1-- 3
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Date of Inspection f
Sep6e System Inspector
Note: In the eveirt that this inspection repoit is used to satist'y the requir��for a moRgage a other traasfa of propedy�be advised that this repoR does not gusrantee
or certity that an e!�ssting sy=tem will oontinue to tunction pmperly.but is merely an opiaion of the adequacy of the system under cutrene conditiong based on the available
info[matioa
CITY OF ORONO � O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON-SITE SI:WA(�E TREATMENT
IN3PECTION REPORT
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Owner:��t91�'I/45 dSl4�-L° `J Address:��97� S��UE� V��� �l2 �
Permit #�'s: S / Datea: � �q��� Contractors: ��D I,�x- l���� ��.
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)
STSTEM CONFORMITY C1-3):
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 satisfactorily by treating and disposing of the entire current sewage input without discharging
any poltutants �nto gro�d 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 failing tor any reason; and any.system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limitin� soil characteristic [ ] has or [ ] has not been identified at this time. If the limiting soil
characteristtc has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-10):
T� inspection indicates:
(5� Pumpout not needed at this time.
`S Solids accumulation in tanks indicates they should be pumped 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 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 pumpout. lf tanks have not been pu�ed out within the last three years, they should be Fxnped
out now.
10 Inspection pipe is located directly over tank beffle (does not give accurate measurement of solids accumulation).
If tanks have not been p�mped out within the last three years, they should be punped out now.
DRAINFIELD CONDITION (11-14):
D field inspection indicates:
�1 Drainfield is dry, no surfacing evident.
12 Some 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 �known.
LIMITING SITE FACTORS (sloce.setbecks,etc.): (,�J�qTE1t-T!4 t-
POTENTIAL fOR SYSTEM fAILURE Cdecends on soils.water table.etc.): !�� — �j/?�Q/�(��
(
COMMENTS( � 5 ! ��� �iDr1� S 5 q �i4K/i��
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at of Inspection Sep 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 witl continue to function
propertyi but is merely an opim on of the adequacy of the system under current conditions besed on the available
informet�on.
This report must be kept on the pre:nises with the system locstion and pumping records.
WHITE COPY/Inspecto►s File YELLOW COPY/Homeowne�
CITY OF ORONO �O�
Municipal Offices O O
Post Office Box bb
Crystal Bay, MN 55323-0066 a � ON-SITE SEWA(;13 TR8AT1�8NT
r�,� �, INSPECTION REPORT
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Owner:�►o�ps � Ros�lynda �s.��c.s Address: ��?_5" Si�VER VicuJ DR.
Permit #�'s:��� � ��Datea: O ��q"f}�Contractors: ( ./01/�'�����1.0.
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 C�IFORMITY (1-3): �
1 "CODE STSTEM"-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 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 waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplein; any
system which mey or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any_system with less than 3 feet of unsaturated soil or sand
between the distributi� device and the limiting soil characteristics.
(The limitin� 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): �
j,�c inspection indicates:
�,�! Punpout not needed at this time.
Sol�ds eccunulation in tanks indicates they should be p�rnped 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 pumped 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 installed in each
tank at next punpout. If tanks have not been punped out within the last three years, they should be punped
OUL �10M.
10 Inspection pipe is located directly over tank beffle (does not give accurate measurement of solids accunulation).
If tanks have rwt been {xmped out within the last three years, they should be punped out now.
DRAINFIELD CONDITION (71-14):
D field inspection indicates:
Drainfie[d is dry, no surfacing evident.
2 Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging �treated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Dreinfield extent and condition �mknown.
LIMITING SITE FACTORS (slooe.setbecks,etc.): �p,-r�2�-f4�D(V
POTENTIAL FOR SYSTEM FAILURE (decends on soils.water table,etc.): �QW _�d���
COMMENTS: �H,��RGi ri 'I — . S �S - 7v r�✓L ' f0
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Date of Inspection Septic ystem 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
properly� but is merely an op�m on of the adequacy of the system under current conditions based on the available
�nformation.
This report must be kept on the premises with the system locetion and punping records.
WHITE COPY/Inapectors Flle YELLOW COPY/Homeowner
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-�'-�,���� � CITY of ORONO
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\ ,t .,�����`ti�'° G Street Address: Mailin�Addross:
r'��F$�1` .¢,'�V
'��xQ 2150 Keiley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Owner: ����Q_ �j ..�� Address: 2675 Silver View Dr.
Permit #'s: 2057 Dates: 6/29/69 Contractors: Clover Aill Co.
(This is [�] an existing system [ ] new construction) .
✓ -
SYSTEM COMPLIANCE (1-3) : 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 is [ ] or is not [ ] identified under this septic system. If the
saturated soil level is not identified, this classification is subject to revision.)
TANK CONDITION l5-91 : 5 '
,�5 �Pumpout not needed at this time.
�6 Solids accumulation in tanks indicates they should be pumped out this year.
7 System is discharging to the surface. Tanks must be pumped out within 48 hours.
8 Inspection risers missing-tanks could not be inspected. If tanks have not been pumped out
within three years, they should be pumped out and risers installed now.
9 Inspection pipe is located over tank baffle-can not measure solids accumulation. If tanks
have not been pumped out within three years, they should be pumped out now.
10 One or more tanks are cesspools, which means the septic system is non-compliant.
(The tanks are [ ] or are not [ ] mater tight or the condition is [ ] unknown. If the tanks
are not confirmed to be watertight, this classification is subject to ev sion.)
DRAINFIELD CONDITION (11-14) : 12
� Drainfield is dry, no surfacing evident.
1 Some evidence of surfacing, not critical yet. Repair is not required at this time.
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.) : high
COMMENTS: In order to confirm that your septic system meets Minnesota standards, soil borings
were performed to verify a 3 foot separation between the drainfield and the seasonal water table.
The separation is 0 feet and the system is non-compliant. Repair or replacement of the septic
system is required by 12/31/2009.
/��� ---�
Da e of Inspection Se ic System Inspec or
Dlote: In the event that this inspection report is used to satisfy the requirements for a
�ransfer of property, this report does not guarantee that an existing system will continue to
inction properly, but indicates the operation of the system under current conditions.
Telephone(612)249-4600 • Fax(612)249-4616
CITY OF ORONO � O�
Municipal Offices O O
Post Office Box 66
Crystal eay, MN 55323-0066 � � ON—SITF. SEWA(�E TREA'1'!lENT
r�,, � IN3PECTION REPORT
'�� G~
9k'EsBo�'�
Owner: '� /1'X/XJ� J.-5��,.� Address: �
Permit #'s: Dates: ' Contractors: �
City ordinance nunber 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 [/7�an existing system [ 7 new construction)
STSTEM CONFORMITY 1-3 :
"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 satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into gro�x�d 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 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.
(The limitin� soil characteristic ,j� has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identi'fied, this classification may be subject to revision.)
TANK COMDITION t5-10):
Tank inspection indicates:
5 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 punped out as soon as possible.
8 System is discharging to the surface. 7anks must be punped out within 48 hours to eliminate surface dischar$e.
9 Inspection risers missing-tenks could not be inspected. Inspection risers (4" dia. pipe) must be installed �n each
tank at next pu�pout. If tanks have not been punped out within the last three years, they should be pumped
OUL r10M.
10 Inspection pipe is loceted directly over tank baffle (does not give accurate measurement of solids eccunulation).
If tanks have not been punped out within the last three years, the sh uld out now.
v n na,�J•
DRAINfIELO CONDITION C11-14):
Dr,a,�nfield inspection indicates:
/1'U Drainfield is dry, no surtacing evident.
�1't Some evidence of surfacing, not critical yet.
13 Drainfield is seturated 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.
LIMITING S1TE FACTORS (slope,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (decends on soils.water table.etc.): ��
COMMENTS:
Date of Inspection Sep c 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 contirwe 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 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—SITE SEWA(�E TREATMENT
r�`,� � INSPECTION REPORT
'�� G~
�
9kESH��'
Owner: � L�Q'aG� Address: �
Permit #'s: fiV� Dates: f� .0 /��/ Contractors: ,
City ordinance nunber 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 f�l an existing system [ ] new construction)
S STEM CONFORMITY 1-3 :
"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 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 may 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 timiting sotl characteristics.
(The limiting soil characteristic ,�L 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 irxiicates:
5 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. 'fanks should be pimped out as soon as possible.
8 System is discharging to the surface. Tanks must be punped out uithin 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 pumpout. If tanks have not been punped out within the last three years, they should be punped
out now.
00 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accurmalation).
If tanks have not been punped out Within the last three years, they should be pixnped out now.
DRAINFIELD CONDITION (11-14): �'
D nfield inspection indicates:
Drainfield is dry, no surfacing evident.
2 Some 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 S1TE FACTORS (slope,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table,etc.): �J
COMMENTS:
.�'�21�-�3
Date of 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 certify that an existing system will continue to function
properly� but is merely an opin�on of the adequacy of the system under current conditions based on the available
informat�on.
This report must be kept on the premises with the system tocstion and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
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
OWNER � � �� ADDRESS . ✓ �� y
PERMIT NO.'S. DATES D���" I CONTRACTORS � �►
City Ordinance No.210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The on-site sewage
treatment system at the above address has been inapected and appears to fall into the category checked below.
(This is � an existing system ❑ new construction)
� � Meets or ex�eds 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 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
upgreding of the system is required at this time.
� 3 Does not meet current City standards in many respects relating to design,construction,or location.Appears to be operating
adequately at this time,but has a relatively high potential for future problems. No major upgrading of system is required at
this time.
� 4 System may or may not meet current City standards for design,construction or location,but is failing to properly treat and
dispose of the current input,and is endangering a water supply,or is a source of pollution to surface or groundwaters,or is
creating a safety hazard,or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/
replacement procedures. If drainfield replacement is necessary,soil testing will usually be required,and a design and site plan
must be submitted for review.Your contractor must obtain a permit before work is started.
SYSTEM CONDITION�m Checked items may require your action)
Tank inspection indicates: �..Inspection pipe is located directly over tank baffle.(Dces not
❑ Pumpout not needed at this time, give accurate meesurement of solids accumulation.) If ta�ks
❑ Solids accumulation in tanks indicates they should be pump- have not been pumped out within the last three years,they
ed out this year to help prevent future problems. should be pumped out now.
❑ Solids accumulation in tanks is at a critical level. Tanks Drain ield inspection indicates:
should be pumped out as soon as possible. �Drainfield is dry,no surfacing evident.
O System is diacharging to surface. Tanks must be pumped O Some evidence of surfacing,not critical yet.
within 48 hours to eliminate surface discharge. � Drainfield is saturated and visibly discharging untreated
❑ Inspection riser9 missing—tanks could not be inspected, effluent to the surfece. This condition may require replace•
Inspection riaera (4"dia. pipe)must be instelled in each tsnk ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanka have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three yeara,they should be pumped out now. ❑ Dreinfield 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 � Low ❑ Fair
❑ Lot size ❑ Medium O Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
❑ Drainage ❑System is causing visible
surface discharge.
COMMENTS:
i�a9-�l
Date of Inspection eptic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of pro�rty,be advised that
this report does not guarantee or certify that an existing system will continue to tunction properly,but is merely an opinion of the adequacy
of the system under current conditio�s based on the available informatio�.
This report must be kept on the premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner