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. '���;;g Minnesota Pollution • • <br /> ��' ControlAgency Compl�ance inspect�on Form <br /> °���� Existing Subsurface Sewage Treatment S stems SSTS <br /> 520 Lafayette Road North �/ ( � <br /> SL Paui,MN 55755-4194 Doc Type:Compliance and EnforGement <br /> (nspection results based on Minnesota Pollution Control Agency(MPCA) For local tracking purposes: <br /> requirements and attached forms—additional local requirements may also apply. <br /> Submit completed form to Local Unit of Government(LUG)and system owner <br /> within 15 days <br /> System Status <br /> System status on date(mm/dd/yyyy): 7/26/2017 <br /> ❑ Compliant—Certificate of Compliance � Noncompliant— Notice of Noncompliance <br /> (Valid for 3 years from report date, unless shorfer time (See Upgrade Requirements on page 3.) <br /> frame outlined in Local Ordinance.) <br /> Reason(s)for noncompliance (check all applicable) <br /> ❑ Impact on Public Health (Compliance Component#1)—Imminent threat to public health and safety <br /> ❑ Other Compliance Conditions(Compliance Component#3)—lmminent thr�at to public health and safety <br /> �Tank Integrity(Compliance Component#2)—Failing to protecf groundwater <br /> ❑Other Compliance Conditions(Compliance Component#3)—Failing to protect groundwater <br /> �Soil Separation(Compliance Component#4)—Failing to protect groundwater <br /> ❑ Operating permiUmonitoring plan requirements(Compliance Component#5)—Noncompliant <br /> Property Information Parcel ID#or Sec/Twp/Range: <br /> Property address: 2160 6`"Ave North, Lonq Lake Reason for inspection: Sale <br /> Property owner: Kevin Scherer OwnePs phone: 952-334-9774 <br /> or <br /> Owner's representative: Representative phone: <br /> Local regulatory authority: City of Orono _ Regulatory authority phone: <br /> Brief system description: 2- 1000 gallon tanks and a ravity trench system <br /> Comments or recommendations: <br /> Couldn't locate any rock trenches, but as-built is attached and based on tank depth the drainfiled must be 30"or more <br /> SYSTEM HAS BEEN DEEMED NON-COMPLIANT BT CITY SINCE 9/24/1998 AND WAS TO BE UPDATED BY 12/31/2010 <br /> Certification <br /> !hereby certify that alI the necessary information has been gathered to determine the compliance status of this system. No <br /> determination of future system performance has been nor can be made due to unknown conditions during system construction, <br /> possible abuse of the system, inadequate maintenance, or future water usage. <br /> Inspector name: Josh Swedlund Certification number: C1659 <br /> Business name: Sewer Se s In License number: 2502 <br /> Inspector signature: Phone number: 952-873-3292 <br /> Necessary or Loc ly Required Attachments <br /> �Soil boring logs �System/As-built drawing � Forms per local ordinance <br /> ❑Other informatio�(list): <br /> www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Available in altemative formats <br /> wq-wwists4-31 • 3/16/12 p�^o *^f� <br />