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��nnesota Poilution Cornpliance inspection Form
Control Agency
520 Lafayette Road North �sting Subsurface Sewag�T�tmant Systems(SSTS)
St.Paul,MN 55155-4144 DOC Type:Comp0enc8 and EntorCement
Inspection resulb besed on Minnesota PolluMon CoMrol Agency(MPCA) For lacel trecking purposes:
requiremeM�and a�tact�ed fom�—addiUonal local requkemenls may also apPly
Submit compkted fomn to Local Unit of GovammeM(LU(3)and syutem owner
within 16 days
System Status
Systetn 6tatu8 on date(mmlddlyyyyj: 7/8l2012
�Compliant--Certificate of Compiiance ❑ Noncompliant—Notice of Noncompliance
(VaNd for 3 yeara hwr►report defe,unless shorter llme (Sae Upgrede Requirernents on pege 9.)
Irarrre ouNi�d in Locel Ordinance.)
Rsason{s)for noncompliance(check all applicab/e)
❑Impacl on Public Heakh(CompBance Component#1)—JmmMent throat to publk health er►d sefety
❑Oiher Compliance Cond�ions(CompUanoe Cornponent 1tik?)—Imminent threa[to publlc health end safsfy
. ❑Tank Intc9�Y(�P�lance Component 1�2)—Fe�to proted groundwater
❑Other CompNence Condittons(Compqancre Component#3)—Failing to protect groundwete�
❑3011 Separation(Complfance Component#4)—FaNing to protect groundwafer
❑OperaBng permiUmoniioring plen requfremenls(Compliance Componenf#6)—fVonraompllant
. Property tnformation paroel ID#or 3ec/1'wp/Ranas:
Property address: 24fi0 Cou�ty Rd,6 Resaon for Inspectbn: Tranefer of PropertY
Prope�ty owner: Steven BouleY Owner's qhone: 783-4T8-6803 ..._._.._..
or
Ovmer's represerrtaUve: KathY end J{m Sewicltl-0oldwell Bumett Rapreaentative phorro: 812-270-1001
Local reguletory authority: Henneain CouMv Regulatoty authority phone:
&ief syst�n deecxlpUon: 2-1260 9aMon tenks and 1-1260 g�on pump tank to e ar�sure ted mound
Commorrts or reaommendatlons: '
Certificat9on
1 hereby cert�y fhat all the neceasery/nformefbn hae been peihered b deferrnlne the oompNar�ce atatua of this system.IYo
�terminatbn of hitws sy�m per/ormance has been nor cen be made dua ta unlmown condHlor►s du►fr�g system conshucBon,
pos�ib�e abuse olthe sY�evn.6radequate mak�tenance,orAr�ne waterusege.
Inspector name: Tristan Ende Ce�on raxunber: C8208
Bueinese name: Ende S Service Llcense number. L2664
Inapector signature. Phone nurnber: 799-428-4489
Necessary or Localty Requfred Attachments
($�Soil bor(ng bgs �SysbmlAs-bullt drawinp ❑F�ne per local orcNnance
❑Other informatlon(Itay: _ �
www.pca.state.mn.us • 651-296-6300 • 800•657-3864 • T1Y 651-282•6332 or 800-657-3864 • Avaflabte tn alGemsdve formats
Mnq•wwlsts4•3f • 3/16/12 Phge 1 of 3
.
Property address: 2450 CounN Rd.8 lnspedor tniC�lslDate: I 7/8/2013
(mrt�Hd�yYYY)
1. Impact on Pubtic Health—Compliance component#1 of 5
Compllanca crlteHa: Verification method(s):
System d{scharges sewege to the ❑Yes �No ❑Searched for s�tace outlet
round surfece. �Searched for seeping tn ysrdlbackup in hane
Syatem diecharges sewage w drein ❑Yes �No ❑Excesslve pondinp in soil systemlD-boxes
tYe or eurfaoe WBtefs. ❑HOmeowne�Mst&t►ony(3es Onmmenfs�xp/snsUw�)
Syatem causes sewage badcup Inlo ❑Yes �No ❑�glack soiP above sal dfspersal system
dweAing or estebNshment. ❑System r ulrea`em
�i ��Y'P�►�P��9
Any"yes"answer above lntllcates the ❑Pe�formed dye test
system Is an lmminent threat to publlc ❑uneble to vertty�ses canmenre�xpr�eaonJ
heslth and s9fefy. ❑other r�thods not Ifeted(sb�commer►fa/Fxp/eneHon)
CommenWExplanatlon:�
2. Tank integrity—Compliance component#2 of 5 �
Com Uance criteris: Verif(caHon ma�od�s):
System consists ot a seepage P�, ❑Yes �I No ❑Probed lank(s)bottom
. cesspool,drywell.or leaching pil ❑Exeurdned onnsvuctlon rec�ds
Seap�e�ts meeHny 70Ao.2660 rraY bs ❑Examined Tank lirtegri(y Fonn(A�ch)
ue�d M bea!orWnenoe. ❑Obeervad Ilquld level belaw operatlng depth
SeWrage tenk(s)leak beto�v their ❑Yea �No
de�gned opereUng depth. �Exsmined empty(pumPe�tanks(s)
If yes,which sewage tank(s)leaks: ❑Probed outalde iardc(s)for'black soiP
My"yes"answer above/ndlcafea fhe ❑unab�e to ve�ily(see cammenta�c�en�on�
system is 1a1/In8 to protect groundwater. ❑�ar methoda not Iiated(sss )
CommentslExpbnadon:
3. Other Comptlance Conditions—comp6ance componer�#3 of 5
a. Maintenanoe hole covere ere dameged�cxacked�unaerxirod,or appear io be ahuchxary unaourxl. D Ys" �No 0 Unlmown
b. Other fseuea(e�f huarda elo.)to immetfli�ely and adve�elY irt�ad P�Nc ttealth or ea(�y. p Yes• �No O uNmown
"Sysfe�n la an G►mtinent threat to pubHc hee/tl►and salf�q. ,
Expl�fn:
c. System is non-proteclive of groimd water for other can�dons�determined by hepedor. p Yes• �No
• 'System!s falllnp to procsct yroundwrter.
Explain:
www.pca.#ate.mn.ix • 651•296-6300 • 800-657-3864 • TTY 651•282•5332 or l00�667-33Si64 • Available 1n eltemaHve fortnats
wq•wwlttaF31 • 3/16/12 � PogP 2 of 3
Properly address: 2450 Count�l Rd.6 Inspector Inktats/Dale: 1 7/812018
(rrx►✓dd�Ys9'Y1
4. Soil 5eparation—Compliance component#4 of 6
Date of instaliation: 1H/1985 ❑Unkrrovm VeriOcation method�s):
�m���� SoN observadon doea not expiro.Prevlous s�l
odg n'g?dlWellhead proteetloNFood beverege �Yes �No obBerveNo/Is by!Nro Independent pa�UeB are suHklent,
uMess sdte condltba►s have 6aen elteisd or kca/
Complfance criteria: requi�eme�►tsdllJ�r.
For sys(ems bulfl prlor to Ap�N 1, 1898,and �Yea ❑No �Ccnducted cdl obtervation(s)(Affach balnq bga�
not Ixated!n Shorelend or WellNead ❑Two prevlous ve�tllcadona(Atfach bafnv bOs)
Proteotlon A�ea ornot serving a fond,
beveiape or lodglrtg estebqshment ❑Not appflcable(F�nD tank(�.m drelMlelap
Drainfleld hes at least�lwo-foot vertical C]une�e co�e�y�co�»,►w�w.�
separatlon distance irom pe�iodtcaily ❑pther(s�ea co�py„eqa,)
eaWrated sdi or bedrock.
Na►-ped�o►mance systems bul�f Apd/i, ❑Yes ❑No CommentslExplanation:
i99Q,orlah�rorfornon-pariamance
syatems locafed iir Sho�efand or WeMhead
ProtecBon/beas oraervinq a food,
beverage,a lod8ing eatab!lshment:
Drair�field hae a ihree-foot verUcd
separeHai distance from periodiceAy
saturated soA or bedrock.*
•ExperimeMal", Other",or 'Pe�famance" p Yes ❑No indiaate de ths or elevations
sy�ems bu�t underpre-2008 Rules;Type IV
or V systems bWlt c�ler 2008 Rules(7080. A. eoriom of di�ullon med� 102.3
2350 or 7080.2400 (Advanced Inspedor
Licen6e required) B. Periodica sad�rotsd sowbedrodc 88.8 end 98.6
Orai�ield mests the designed vertfcel C. S ee tbn 3.7 and 3.8
separation distance from pedod�ally
satureted soll or badrodc. D. Reauired camolianae s�eretbn• 2.0
Any"no"answer above lndlcates the system!s '�y be reduced up to 18 percant if abowed by Locel
falling to protect groundwater. Ordinance.
5. Operating Permlt and Nitrogen BMP"'—Compliance aomponent#g of 5 �Not applicabla
Is the system operated under an Operadng Pertnit? ❑Yea ❑No If"yes",A balaw Is raqutred
la tho syetem required to anpby a Nitrogen BMP? ❑Yea ❑No 1/"yes",B below ia roqulrod
• BMP=Best Menegement Practice(s)apec�ied!n the syslem de�gn
If the answar to 6oU�queallons is"no';th/a sectlon does not need tn be oompleted
Compiiance cribri�
a. Operatfng PermR number:
Have the O rapn Pertnft r ulremerda been met? ❑Yes ❑No
b. Is the red nitro n BMP in sce and tunctbn ? Yes No
Any"no"answer Indlcate�Noncompllanca
u�na.rt.c,u�roments r,�nn.s�a��i�s.s61 a�r�nsn�n�oer a w�no►�n�a�a mp++s�muar ae uio�aed,►daao.d,a x��e
diaoontlnwd wkhln ten monfhs otnos�}ot af Nda noNos or wNhln e+hater pertod�f roqufrod bybal a�rrinencs.J/N�s ay�sNm/a/e6h►g(io�otecf
pround watsr,Elte sYB�em muaf be upproded,roplaosd,or da use decontMued wNhln NJe 44ne►eQvrksd 6Y bcal o�dNp�nc�.M an wtbfkp ayslam
k rat IeM�y aa defrred in law,and hes at leeat hvo Aaet of dsaip►aoll aeparsUa►,�en ths ayafsm nsed not be�edsd roPabed,►eP/eoed,e►
f�we�ocMlrwed,noAvlfhata►dhp any baa/adlnanw Uwt Is mae ahfaf.TMa provlelort doa�at apply fo syatans&�ehadend aisaa,
WeDhead Protxflon Aree�,orllno�ussd M crorr�ecdor►wYh toa�beve/eps,and fotl�np eateb6ahms�a aa dslMed!n law
www.pcastate.rt�.us • 651•2%-63a0 • a00�bs7•3864 • TTY 651-282•6332 or 800-657•3!W • Avallable b al0emattve formats
wq•wwlsts4•31 • 3/ibl 12 Pqqe 3 0/3
Ende Services Soil Log
Client/Address- 5te�ve Boulay Legal Description/GPS: 2450 Cty Rd.6 Long Lake.NW
soa parent materia�(s):(chedc aU tt►ac appty) O o�a�t, �taa�e O t� ❑� ❑�n ❑ee�oa ❑a�c►�mc
Landscape Position-{check one) ❑summit ❑� ❑ee�k/Side sbx ❑roa 5bpe ❑Tce sbpe Slope shaPe
Vegetation Grau Soil survey maP units Slape% Elewntion: 98.6
eather Cnnditions/T'ttne of Day: Sunn�►/2pm D�ate 07/081t3
Observatlon�/Lxatton: #1/soutMide of mound Observation Type: A�er
1-----StR7ChJFe----^i
pepth(in) TeuWre F� Matrix Cotor(s) NbtUe Cobr(s) Redooc Ktndts) �torys) Grade Co�sistence
i �
0-12 Laam tOYR 2/2 , ; �kY �� �
, . .
� , � �
-•- •- -- - -- --- .--- ---• ._. .... •..._ -�-i---• ...
12-22 , Clay Lnam , � 10YR 3/� } Concentrattons � Blodry Modera�e � Flrm
' _ i _ _ _. .._ ..... � •-- --.._ _._.. - -- -
-�-- --- � i ' �
� � �
I I �
-- - -- --��`-- - - - -I - — ..._ _. __ .
i �
F �
? ! { � i
E '
i i ' ..._._-_-i---.. . 1
----. . ._ ..__ ._..._ �- -----�._.� ..__ - - •--
. i
: :
.
.�._ �_ ------.. _ ... .__� . . . .__ . _.-_� _ ��. ..�
• � � E
� +
CGft11112�1t5 •
I hereby ceNf�r that I have compleLed this work in acxordance with aH app6cable or�inances,rules and iaws.
Tristan Ende -C�¢�- C82a6 7/8/2013
(Dtsi�►►er/lnspector (Signature) L3cer�t (��)
Soi l Log
Uient/Address: Steve Bouley Legal D�scription/GPS: 2450 Cty Rd.6 Long Lake,M1'�
'l pnrent materiaL(s):lCheck alt that appl� ❑one�esh ❑� ❑� p„u ❑na� ❑e� ❑��►
tandscape Pos;tion:(cneck«,e> O�D� O�s�ova ❑rboc swv ❑roQ s�e slape snape
Vegetation Grass Soil�m� Slope75 Elevation: 98.5
eather C.onditiauTme of Day: SunrN�2Pm Date 07/08/13
Observation#/Location: 82lnorthside of mo�d abservatior►'lype: ��
1--------Structure---------i
pepth(in) Texture � MaLix Cotor(s) Mottle Color(s) Redooc Kind(s) InditaLor(s) G�� �
0-10 Loam 70YR 2/2 i BEodcy Ahoderats Firm .`
10-20 . C Loam ' � 10YR 3/4 � � Concentcations .. Blocky :� AAoderate ' �rT^
..� _ ..-- •-�—r-� __ - - • - ' ��
�_ � - -- �- -• - � _�� --
� � i � i
- '--- - ... '. . .. - �--•-•"--t--- ..�� __ � ~ -
. _._ _._ .. ... .-- ' i
Comments
observation#�t.ocation: Observation Type-
F--- '�
Depth(in) Texture F� Matrbc Color(s) Mottle Color(s) Redaoc Kind(s) Indicator(s) Sha Grade �0��^�
, ' i
. ! �
; � i
' ._ .. �._� -- �–� � -- _
-- _. � ...
� . _. . � - ---#—.. ._. _
^ � - � _ �_, � .. _ ... • '�.�"..'���� �-� 'T'_-..- _. .
T I
.. ...__ - --1-- - —• - -- I .. ... _ ; _ ..�_._ � -.•{— .__—
� � i
_. � . . _ - -- -- -- ,_�I' —�- -- --
�
. i .
CORIIT12f1LS
Textures: Subsoil Indicator(s)ot SaWration: �Ce:
��y 1.Dlstinct SrdY or red redox feawres �. lntact spedmen rat available
sic-silty clay S2.Depleted mat�ix(value�/-4 ard chroma</�2j Friabte- Sti�t foroe betvreen fir�ers
sc-sandy clay 53.5Y chroma<!=3 • Moderate force betw�een fingers
54.7.5 YR or redder falnt redox concentratians or redox deple Moderate f�oe between hands or stight
d-claY loam rm- foot pressure
-sftcy daY�� If yes to a�e af the above indkators then: Foat preuure
sd-sandy ctay loam apaoil Indicator(s)of Saturalion: �P��=
si-silt 1.Wetland Vegetatton Stope�ape is desaribed�trw directlon�up end doMm Sl�e
sit-silt loam 'Sand Modlfiers 7'2.Depressio�nal Larbscape (perpendicular to the contourl�and avoss slope(alon8 the
1-loam co-coarse T3.OrgaMc texture or organic modi�iers ho�izontal contour);e.g.Linear.Convex or LY.
sl-sandy loam' m-rnedium 4.N 2.5/0 cola� . • •
Is-loamy sand� f-fine .Redaoc fe�tures in topsoil
s-sand' vf-very ffie 6.hlydrautic indicators ` �. • � � �
Soil StrucWre
Cxade: � .
�vg_ No observab4e a�►eBates,or no arderiy arrar�gement of nawral lines of wealaiess - � �
poor(y formed,indiscinct peds,barely�servable in place - - • . •
rate- Well fom�ed,distirxt peds,moderately durable and eviderrt,but not distinct in
Durable peds that are quite evident 9n u�-disp[aced soil,adhere w�eakly m a�e another, ' :
withstand displacemerrt,and become separated when soil is disturbed .� � �. • ►
a xa • wl a:
No peds,sandy sotl sun-�-� .
•- itihuu:Osr • ►
50��S�fUCttlf�' � Dae�l3:A�4.w� � . .� . � � �•
Shape: ' T�.��r»
G n - The peds are approximately sp�l or polyhedral and are commonly found in topsoil.Tf�ese ar+e the smatl,rounded peds that hang onto roots
P - The peds are flat and plate tike.They are orlented ho�izontally and are usualty overlapping.Platy sm,cc�ce is commonty found ia forested
Bt - The peds are block-like or polyhedra[,and are bounded by flat or slightly rour�ded wrface that are casting of the faces of wrrounding peds.
Prismatic• Flat or slightty rounded vertical faces bound the individ�al peds. Peds are distinctly tonger vertically,and faces are typicaUy cast or molds of
Si le Grairr The structure fau�d in a sandy sail.The individual partides are►�ot held together.
Property ada.ess:
2450 Cly Rd.6
�ong lake.htw SB 2 R�
Bed
gallon pump ��
tank
� — — — — --'
I Mound
I � -1250 gallon tanks Q
21' f
` p 581
pme1Yy�, Elevations:
carage H� s�a�:loo.o
Bottom ot►iockbed-102.3
561-�36_6
SB2-98S
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;; Municipal Offices
\`�� �I � G~���� Mailin Address:
Street Address: S
��9,kEsxp'4�� 2750 Kelley Parkway P.O. Boz 66
' Orono, MN 55356 Crystal Bay, MN 55323•0066
To: The Current Owner of Address � 't �� � ` �'�`�
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 beeii 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 receipt of tliis 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,must be brought into compliance by:
December 31,2007
December 31, 2010
Other
Septic Tank(s mp out Needed
Yes
No '
The City recommends the septic tank(s) and/or lift tanl:be serviced and pumped
out every three years. City records indicate the tank(s) were last pumped out on
'j -- � 'C� ���1 . The tank(s) should be cleaned through the manhole and
not tivough the inspection pipes,this allows for proper cleaning.
Comments:
Y.
Ins e��� .�,_.�'t _ . �°: Date of Inspection �� D �
P
'g'elephone(9�2)2�5-w600 � Fa:� (9�?)2�9-46�a5
www•.ci.orono.rnn.t�s
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��� CITY of ORONO
r�! ,'��` �T� �+
\ '�,� B': �l�r Municipat (�t'ices
�, � ,�,G street rlddress: alsa-a49-'i6o o M�utut Ad�eas:
,�,gg�0'�" 2750 K�elley Parkway P.� B�c 56
Orono, MN 55356 Crystat 8ay, t�+l 55323-0066
To Current Owner: Address: ��S� S�� '7`�'e- /" �
City Ordinance 199 requires t�ai each existing on-site sewage treatment system in Orono be inspected every two yeazs.
The on-site sewage treatment system at die above address has�beet►inspected and appears to fall into the categoria checked below.
YSTEM COATFORMITY (1-3): �
_ . . _. _ _ _ __ ..
_1 -��CODE SYSTEM"An LSTS which meets all the location,design snd construdion standards of the caurent Orono Municip�al Code.
2 "COMPLIANT SYSTEM" An�STS which does not mee�all the location,design�d cwnslruction stanc�rds of the caQrent Orono
Mxwicipal C.ode but does me�the Uure foot separation requirement or two�oot requir�nt for systems installed 1996 or earlier,and
which is mt�ling�au i�in�t threat to public hea1W or s�ty.
3 "NON�OMPLIANT SYSTEM" A pn►h�sd IS1s;an LSTs locatoa w;min a aesig�oated loo-reffi flood Plain,any rsls which roay
or�y not meet all the location,desi�,�cwnstrudion �andards of tbe c�urent Orono Municipal t',ode and which is fa�7ing�r any
reason;�d any ISTS with less Wan fhree fe�of�msaturatod so1 or sand b�.wcen the dishibuti�device�d ihe l�iting soil ch�actaistics.
TANK CONDiTION(5-71: t'�
Tank inspedion indicates:
5 Pumpout not needed at this time.
6�.Septic tanks must be pumped out ti�is year (city code recommends#anks to be pumped c�ut once every 3 years.
Tank was last pumped, ) .
Make sure se�c tasks are n■�aed i�rou�h�sehok aad aot f�rou�w4ite i�saection ait�s. T'�is allows for t�e uroaer
ckaAieg. Keeu�vater softaer sad ir�n 5lterdisc6ar�e out of seutic soste�to nroloag life af dnin5eld. Ask numner to te.st
aiarm float te verifv alar�is�i1i worlriee m voar bou.se. T'�e alar��varas orrner t6at senta�e�s xboat to baek�a iato b�sement
7 Inspedion risers missing-tanks could not be inspected. Inspaction ris�s(4"dia.pipe)must be installed in each tank. If
tanks have not been putnpad out within the last three years,they should be pumped out now.
DRAINFIELD CONDTTiON 8-lfl : � ,
8 Drainfield is dry,no surfacing evid�t
9 Some evidence of sw-facing,aot critical yet.
10 Ihainfield is saturated and visibly dischargin�untreated effluent to the surface. Contact the City�nspactor
immediately.Repairs must be completed within 9U days.
COM1Vk�EN'TS: U v�• 0 OY-S 0�., P U� S( �,�..
S�P r�-r l<' 3-���
.. . ` �.�\� O� . `� '_ 7 � � . .
Date Of inspaction Matt Bolterman- Se�c SYstcm Inspeaor
I�ote: In the evmt ihat this inspecxion repnt is used to aatisfy dte t+equu�uts for a mortgage�oWa�aosfer of propaty,be advised that lhiz t�epoit tices
not guaranta or ceatify.tliat�existing system w�l.00atinue to fimc�ion P'�P�Y, but is m�ely an opinion of t�e adequacy of the system�mder current
aondidons b�ed an the avalabk in#'oimation.
� o�.
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,� �}�����.��, CITY of ORONO .
.
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�l �'%;};�;;,�� �'yG ' Street Add�ess:
� �g Mailmg Addrau:
�:SII 2150 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystai Bay, MN 55323•0066
. 95d-�yq-y600
To Current Owner: Address: o�y S� S'�}'� �1/C. �✓
Ciry Ordinance 199 requires that each existin�on-site sewage treatment system in Orono be inspected every two years.
The on•site sew�a�e treatment system at the above address has been inspected and appears to fall into the categories checked below.
STEM CONFORMITY 1-3 : �
1 "CODE SYSTEM"An ISTS which meets all the location,duign and conswction staadards of the current Orono Municipat Code.
2 "CO�LIANT SYST'EM" An iSTS which daes not meet all the lacatian,daign and consuvction standuds of the eurrent Orono MunicipaI
Code but does meet the three foot separadon rcquircment or two foot requ'uement for sysurru 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-year flood plain,any ISTS which may
or may not meet a11 the location,duign,or construction standards of�e current Orono Municipal Code and which is failing for any reason;and
any ISTS with less than three feet of unsaturated sail or sand between the d'uaibution device and the limidno soil eharacteristics,
TANK COWITION(5:71: 6 �
Tank inspection indicates: . , :
5 Pumpout not needed at this time. �
�Septic tanks must be pumped out this year (city code requires tanks to be pumped out once every 3 years.
Tank was last pumped 7-5-�y �, �
hlake sure septic tanks are oumoed through manhole and not through white insoection pipes
This allo�ti�s for the proaer cleanin¢.
7 Inspection risers missing-tanks could aot be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
D INFIELD CONDITION -tQ : �
8 Drainfield is dry,no surfacing evident. -._
9 Some evidence of surfacing,not critical yet. � --6s �
10 Drainfield is saturated and visibly discharging uncreated effluent to the surface. Contact the Ciry Inspector
immediately.Repairs must be completed within 90 days.
COI�I►�`, NTS: C r�o��� G:.� se }� c. +��ks look o�C_ �v� sc �-,�.
�C�t�C-� �+c- �t�� ����iC l�G�fi �C�C� ,Q�_rt �-�.-� :^ �`S�- � ��f�'S �
10 -� -v1, �r\� ��'���--��
Date of Inspection Matt Bolterman— Sepde System Inspector
Note:In the cvent that this inspection rcport is used to satisfy the rcquirements for a moctgage or other transfer of properry.be advised that this rcport does not guarentc:
orceaify thzt an e:cistiag rystem wiU continue to function properly,but is rnereiy an opinion ofthe adequary of the system under current conditions bised on the avaiJabte
inCormadon.
CITY OF ORONO �O�
Municipal Offices O O
Post Office eox 66
Crystal eay, MN 55323-0066 � � ON–SITE SEWA(�E TREATMENT
INSPECTION REPORT
ti
h
��9kESII��'�G
Owner: .S�^�E 1/'l� �DLt �Q-� Address: 2 y$v SiX rv1 !�I/��v / �53�b�
r
Permit #�'s: �y�� Dates: I�i�–o�7—�Contractors: �il/idi'Ii�7t �ORDS.
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 � an existing system [ 7 new construction)
S1'STEM 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 alt 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-CONPORMING 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 limiting soil characteristics.
(The limiting soil characteristic j�has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identifie2J, this classification may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
5 Punpout not needed at this time.
(� Solids accumulation in tanks indicates they should be punped out this year to help prevent future problems.
T Solids accunulation in tanks is at a critical level. Yanks should be purtiped out as soon as possible.
8 System is discharging to the surface. 7anks must be punped out within 48 hours to eliminate surface discharse.
9 lnspection risers missing-tanks could not be inspected. Inspection risers (4" dia, pipe> must be installed �n each
tank at next pumpout. If tanks have not been punped out within the last three years, they should be p�mped
out now.
10 Inspection pipe is located directly over tank baffle (does not give accurate measurement of solids accunulation>.
If tanks have not been p�mped out within the last three years, they should be punped out now.
DRAINFIELD CONDITION C11-14): �
D�field inspection indicates:
1 Drainfield is dry, no surfacing evident.
Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated efftuent to the surface. Contact the City lnspector
immediately. Repairs must be completed within 90 days.
14 Orainfield extent and condition unknown.
LIMITING S1TE FACTORS Cslooe,setbecks.etc.): �–
POTENTIAL FOR SYSTEM FAILURE Cdecends on soils,water table,etc.):
COMMENTS•
�
Dat of Inspection Septic 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
informetion.
This report must be kept on the prerises with the system tocetion and p�nnping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
_
i= � ���
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'� � � ������ CITY of ORONO
�� '�'�'���T';� ���'
� �� �` ���t �'� Municipal Offices
i L„,: �i � •, ti
�,� � g ``�i�`,'�G Street Address: Mailing Address:
9 ������r��� �� 4
��CEggO , 2750 Kelley Parkway P.O. Box 66
�=_--_
CITY OF ORONO �O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 a � ON-SITE SEWAI3E TREATI�:NT
� �, INSPECTION REPORT
ti
��9kEsxo�'�o
Owner• ✓� � Address• �7C�0 �✓Y�� !V�
Permit #'s: T� Dates: h �7"� T Contractors:_ ��/YJ�IPY I�YOS,
.
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 L�1-an existing system [ ] new construction)
YSTEM 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 limiting soil 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 (5-10):
Tank inspection indicates:
5 Pumpout not needed at this time.
6 Solids accixnulation in tanks indicates they should be puniped 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.
� System is discharging to the surface. Tanks must be p�nped out within 48 hours to eliminate surface dischar�e.
Inspection risers missing-tanks could not be inspected. Ins ction risers (4" dia. i mus tn each
tank at next p�xnpout. If tanks have not been ui in ree years, t ey shou
oi7L-now. -
10 lnspec�'i3T5'�STpe is located directly over tank baffle (does not give accurate measurement of solids accunulation).
If tanks have not been pumped out within the last three years, they should be pumped out nou.
DRAINFIELD CONDITION (71-14):
Dr tield inspection indicates:
1 Drainfield is dry, no surfacing evident.
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.
LIMITING SITE FACTORS (slope,setbacks,etc.):
POTENTIAL fOR SYSTEM FAILURE (deaends on soils,water table,etc.): /��
c
CO NTS: / - _,
Date of Inspection ptic ys em nspector
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 opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the prE�nises with the system locstion and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
On the North Shore 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 �/�� ��//1 ��+/'��
PERMITNO.'S. ��6� DATES [����� CONTRACTORS G�/�`!ll�� ✓�5,.
City Ordinance No.210 requires that each o�-site sewage treatment system in Orono be inspected on a regular besis.The onsite sewage
treatment system at the above address has been inapected and ap�ars to fall into the category checked below.
(This is �an existing system ❑ new construction)
�� Meets or exceeda current City standards in all respecu relating to design,construction,and location.Appears to be operati�g
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 meny 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 a�d
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 Inapector to discuss system repair/
replacement procedures. If drainfietd 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 inapection indicates: ❑ Inspection pipe is located directly over tank baffle.(Does not
❑ Pumpout not needed at this time. give accurate messurement 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 Drain ield inspection indicates:
should be pumped out as aoon as possible. �Drainfield is dry,�o surfacing evident.
❑ System is discharging 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 risen missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risera (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 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, nd system condition) �-Adequate
High water table Low ❑ Fair
❑ Lot size Medium ❑Poor
❑ Lake,wetland,or stream ❑ High ❑ Inadequate
� Drainage ❑System is causing visible
surface discharge.
COMMENTS: �~� p✓� / � � ���
�-1,�-9�
Date of Inspection eptic System Inspector
Note: I� the event that this inspectio� report is used to satisfy the requireme�ts for a mortgage 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 on the premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner