HomeMy WebLinkAboutseptic info ���,��� Minnesota Pollution
��� »� Compliance Inspection Form
: Control Agency
520 Lafayette Road North Existing SubsurFace Sewage Treatment Systems (SSTSj
St.Paul,MN 55155 4194 Doc Type:Compliance and Enforcement
InSpeGtion results based on Minnesota Pollution Control Agency(MPCA) For local tracking purposes:
requirements and attached forms–additional local requirements may also apply. aDD � � �O��
Submit completed form to Local Unit of Government(LUG)and system owner f ��
within 15 days
i-
System Status
System status on date(mm/dd/yyyy): _4/13/2015
� Compliant—Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on pape 3.)
frame outlined in Local Ordinance.)
Reason(s)for noncompliance(check a/l applicable)
❑Impact on Public Health (Compliance Component#1)–lmminent threat to public health and safety
❑Other Compliance Conditions(Compliance Component#3)–Imminent threat to pu6lic heafth and safefy
❑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
❑Operating permiUmonitoring plan requirements(Compliance Component#5)–Noncompliant
Property Information Parce)ID#or Sec/Twp/Range: 28-118-23-41-0004
Property address: 2500 SIXTH AVE N Reason for inspection: SALE
Property owner: LEW A ERICKSON Owner's phone: 612-990-5292
or
Owners representative: Representative phone: _ __
Local regulatory authority: City of Orono Regulatory authority phone: (952)249-4600
Brief system description: Two tanks lift tank,mound
Comments or recommendations:
Certification
1 hereby certify that all the necessary infonnation has been gathered to determine the compliance status of this sysfem.No
determination of future system performance has been nor can be made due to unknown conditions during system const�uction,
possible abuse of the system, inadequafe maintenance, or future water usage.
Inspector name: Chris Berq Certification number: C9523
Business name: Techtron Enqineerinq,Inc. License number: L1172
Inspectorsignature: �.--'",__–.'�_} _,_..—�-`'�..�.__� Phone number: (763)712-9502
�S
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 • Availablein alternative formats
wq-wwists4-31 • 3/16/12 Page 1 of 3
Property address: 2500 SIXTH AVE N Inspector initials/Date: CB � 4/13I2015
(mm/dd/yyyy)
1. Impact on Public Health—Compliance component#1 of 5
Com liance criteria: Verification method(s):
System discharges sewage to the ❑Yes �No �Searched for su�face outlet
round surface. �Searched for seeping in yard/backup in home
System discharges sewage to drain ❑Yes �No �Excessive ponding in soil system/D-boxes
tile or surface waters.
❑Homeowner testimony(See CommentsiExplanation)
System causes sewage backup into ❑Yes �No ❑"Black soil"above soil dispersal system
dwelling or establishment.
❑System requires"emergency"pumping
Any"yes"answer above indicates the ❑Performed dye test
system is an imminent threat to public ❑Unable to verify(See Comments/Explanation)
health and safety.
❑Other methods not listed(See Comments/Exp/anation)
Comments/Explanation:
No seeping or backup,no excessive ponding in soil system.
2. Tank Integrity—Compliance component#2 of 5
Cam 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 tiant 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: ❑ Probed outside tank(s)for"black soil"
Any"yes"answer above Indicates the ❑Unable to verify(See Comments/Explanation)
system is failing to protect groundwater. ❑Other methods not listed(See Comments/Explanation)
Comments/Explanation:
Liquid level was at opera6ng depth.
3. Other Compliance Conditions—Compliance component#3 of 5
a. Maintenance hole�vers are damaged,cracked,unsecured,or appear to be structurally unsound. ❑Yes* �No ❑Unkrrown
b. Other issues(elecbical hazards,etc.)to immediately and adversely impact public healtfi or safety. ❑Yes* �No ❑Unknown
"System!s an Imminent threai to public hea/th and safery.
Explain:
c. System is non-protective of ground water for other conditians as determined by inspector. ❑Yes' �No
"System!s talUng to protect groundwater.
Explain:
www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • TTY 651-282-5332 or 800-657-3864 • Availabte in alternative formats
wq-wwlsts4-3t • 3/16/12 Page 2 of 3
. , �
Property address: 2500 SIXTH AVE N Inspector initials/Date: CB I 4/13/2015
(mm/dd/YYYYI
4. Soil Separation—Compliance component#4 of 5
Date of installation: 7/18/1984 ❑Unknown Verification method(s):
(mm/dd/yyyy) Soil observation does not expire. Previous soil
ShorelandNVelihead protectionlFood beverage �Yes � No observaiions by hvo independent pafies are suffrcient,
lodging?
unless site conditions have been alfered or local
Com liance criteria: requirements ditfer.
For systems built prior to April 1, 1996, and �Yes ❑ No �Conducted soil observation(s)(Attach boring logs)
not located in Shoreland or Wellhead
Protection Area or not serving a food, ❑Two previous veriflcations(Attach boring logs)
beverage or lodging establishment: ❑Not applicable(Ho/ding tank(s),no d�ainf,etd)
Drainfield has at least a two-foot vertical ❑Unable to verify(See Comments/Explanarion)
separation distance from periodically ❑Other(See Comments/Explanation)
saturated soil or bedrock.
Non-performance systems built Ap►il 1, ❑Yes ❑ No Comments/Explanation:
1996, or later or for non-performance
systems located in Shore/and 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" ❑Yes ❑ No Indicate de ths or elevations
systems built under pre-2008 Rules;Type!V
or V systems built under 2008 Ru/es(7080. A. Bottom of distribution media 101.4
2350 or 7080.2400 (Advanced Inspector
License required} B. Periodicall saturated soil/bedrock 98.6
Drainfield meets the designed vertical C. S tem se aration 2.8
separation distance from periodically
saturated soil or bedrock. D. Re uired com liance se aration` 2.0
AI?y"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? ❑Yes ❑No li"yes",A below ls required
Is the system required to employ a Nitrogen BMP? ❑Yes ❑No If"yes",B below is�equlred
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.
Com liance criteria
a. Operating Permit number:
❑Yes ❑ No
Have the O eratin Permit re uirements been met?
b. Is the r uired nitr en BMP in lace and ro rl functionin ? ❑Yes ❑ No
Any"no"answer indicates Noncompliance.
Upgrade Requirements(Minn.Stat.§115.55)An imminent threat to public health and safefy(ITPHS)must be upgraded,replaced,or its use
discontinued within ten months of receipt of this notice oi within a shoiter period if required by/ocal orclinance.H the system is failing to protect
ground watei the system must be upgraded,rep/aced,a its use discontinued within the tima required by/oca/ordinance.lf an existing system
is not failing as defined in/aw,and has at least iwo feet of design soil separation,then tha system need not be upgraded,repaired,replaced,or
its use discontinued,noiwithstanding any Ixa!oniinance that is more sfrict. This provision does not apply to sysfams in shoreland areas,
Wellhead Profection Areas,or those used in connection with food,6everage,and lodging establishments as defrned 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-wwfsts4-31 • 3/16/12 Poge 3 of 3
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,`.�� .; ., ';; CITY of OIZOI�TO
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,,, ,�,� �; ry `,+ � ��,;,, Municipal Offices
� '`, � . " '` � � Street Address: Mailing Address:
�9�E$xp'4�� 2750 Keiley Parkway P.O. Box 66
--.--.. Orono, MN 55356 Crystal Bay, MN 55323-0066
To: The Current Owner of Address � �� �� ��'f�
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 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 10
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 Identified as Non-Compliant
Yes �No
If yes, system rnust be brought into compliance by:
December 31, 2007
December 31, 2Q10
Other
Septic Tan��ump out Needed
Yes
No
The City recoirunends 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 -�{�i . The tank(s) should be cleaned tl�rough the manhole and
not tluough the inspection pipes,this allows for proper cleanina.
Gomments:
���'��,, "�� � - � �
Inspector: Date of Inspection ��` � �
'fle�ephor�e (9j2)249-=�600 � �'ax(9�2)249-�6��,
VY W'SM1'.C1.03'OH10.bd3f6.ldS
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-�� ��� : �ITY of �RONO
'� 1��,� '�:;.- - � Municipal otfices
�'� '� �~ qsa-�►4q-yb�
S1f0et AddI�ESS: � MeINQ�AddrBSB:
�,���"� 2750 Kelley Parkway � P.U. 8ar 66
Orono, MN 55356 Crystal �r, MN 55323-0066
To Current Owner: Address: a s6� s� ��t, J�/�
City Ordinance 199 requires that each existing on-site sewage treahnent system in Orono be inspected every two years.
The on-site sewage treatme,nt system at the above address has been inspected and appears to fall irrto the c.ategories checked below.
SYSTEM CONFORMITY 1-3 : �
- �
_____ __. _- _
T "COI�E-SYSTEM"An ISTS vvhich meets all me location,design and conshudion standards of the curreut Orono Municip�l C.ode.
2 "COMPLIANT SYSTEM" An ISTS whic�h does not meet all the locstion,design and conshuction standards of the currmt Orono
Mnnicip�l('.ode Mrt does maet f1�Wree foot separation nequu+ement or two foot requirem�t for syst�s installed 1996 or eadier,and
which is nc�t�iling or an i�ineat Wreat to public heahh�safety.
3 "NON-COMPLIANTSYSTEM" A�ib;ted ISTs;ffi ISTs bc�w;min a aesignatea loo-year aooa plsin,ffiy rsTs which may
or may�mee�all We location,design,or convh�uction standards of the caureat Orono Municipal Code and which is ia7ing fior any
reason;ffid any IS1'S with less th�thrae feex of unsaUuated soil or sand betwcen the disln'bution device and the limiting so�7 chazact�istics.
TANK CONDTTI�N(5-7): b
Tank inspection indicates:
5 Pumpout not needed at this time.
6[��Se,ptic tanks must be pumped out this year (city code recommends tanks to be pumped out once eve,ry+3 yeazs.
v Tank was last P�P�. �•
Make sere sentic taeks sre��ned Wraas6�eLole a�d.ot t6roa¢h wLite i�saection niaes. T�is albws for tke urocer
cleanie�. Keeu w�ter softaer aed iroa Slfer diseiar�e oat of�fic s�ste�to aroloag life af drai�field. Ask oamcer to test
a�arm float te verifv�lar��still worltiee ia voar�onse. The alar�war�s oweer t`at seatase i�aboat to backua into basement
7 Inspection ris�s missing tanks could not be inspected. Inspection nsea�s(4"dia.Pipe)must be installed in e,�ch tank. If
tanks have not bee�►Qumped out within the last tlirce years,they should be pwnped out now.
D INF�LD CONDTTION f8-lfl): � ,
��eld is dry,no surfacing evide�t.
9 Some evidence of surfacing,not critical yet.
10 Drainfield is saduaxed and visibly discharging untreated e$luent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 9U days.
COMMENTS: /`^n �^� � b 6�.5 0�� �v� S C}�,--c_ ���1� S J,��•.�c/"
�a�—
1 b -�t-�� 0�,.; �,�
nate of tnspecnon t�taa solt�nna�►- sept;o syscem Inspeccor .
Note: In the event t�at Wis inspa�ion repoit is used to satisfy.the requ�ts for a mortgage�otha transf�a of pmp�ty,be sdvisod ihat this repaat does
not guarantoe or oatify dwt an eldsting syste�w�71 contmue to fimction properlY> but is maely aa opini�of the adoquacy of tLe syatcrt►under cmreat
couditions based on the ava7able�afamatian.
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���r� CITY of ORONO �
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��O�i�j-^��,� G� biunicipal of�ices
't ,,.Yti�� ,�i • Streat Address: .
��"Hpg Malling Address;
2750 Kelley Paricway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
� 95d-�yq-y600
To Current Owner: Address: d Sd 0 S;Xf� A�e f�,
City Ordinance 199 requires tliat each existina on-site sewa�e treahnent system in Orono be inspected every two years.
The on-site sewa�e treatment system at the above address has been inspected and appears to fall into the categories checked below.
SYSTEM CONFORMITY 1-3 : �
1 "CODE SYSTEM"An ISTS which meets all the location,design and construction standardc of the cumnt Orono hiunicipal Cadc.
2 "COMPLIANT SYST'EM" An ISTS which does not meet all the location,desian and construcdon standards of the current Orono Municipal
Code but dou meet the three faot separation requirement or two faot rcquirement for sysums installed 1996 or earlier.and which is not failina or
=an lmminent threat to public health or safery.
3 "NON-COMPLIANT SYSTEM" A prohibited ISTS;an ISTS located within a daignated 100.yeu flood plain�any IS?S which may
or may not meet all the location,design,or conswcdon standards of�e 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 disaibudon device and the limitino soil characteristia.
TANK CONDITION(�-:7): � �
Tank inspection indicates: . _
S Pumpout not needed at this time.
6O Septic tanks must be pumped out this yeaz (city code requires tanks to be pumped out once every 3 years.
Tank was lazt pumped_ g-7-Q� �, �
1�Iake sure seotic tanks are oumoed throuoh manhole and not through white insnection oioes
This allo�;•s for the orooer cleaninQ.
7 Inspection risers missing-tanks could not be inspected. Inspection risers(4"dia.pipe)must be installed in each tank.
RAINFIELD CONDITION -tQ : �
8 Drainfield is dry,no surfacing evident. ,_
9 Some evidence of surfacing,not critical yet. =�= �
�
10 Drainfield is saturated and visibly dischargina urltreated eftluent to the surface. Contact the City Inspector
immediately.Repairs must be completed within 90 days.
CO��NTS: r����J a�� s��+-� t��ks I�e� o I�_ P��Q s:pt:�
�- � - � �_
a1Z`F S R• •^�1 � �'� � �Rvt r`o�. �r+,, Fv..pto v...�'1, ;�. 14s�- 3
--\�tc:�C S . .
IU -� - C�- '✓�'�� �
Date of Inspection biatt Bolterman— Se tic S stem I
p ' y nspector
Note:In the evenc that this inspection report is used to satisfy the requirements fa�a martoage or othet trarufer of properry.be advised that this rcport does not gusr3ntee
or certify that an existing rysten wi11 continue W funcdon properiy,but is merely an opinion ofthe adequary olthe system tmder eamnt conditions based on the availabie
information.
To: Street File
From: Chris Pence, On-Site Systems Manager
Date: October 1, 1999
Re: Septic System at 2500 Sixth Ave N.
A site inspection was conducted to determine if the existing three bedroom septic system is in
compliance with current city and state codes.
The septic tanks appear to be watertight and are of the proper sizing for a three bedroom home.
The drainfield is a standard mound. This mound system achieves the state required three foot
separation to the ordinary high water table. At the time of inspection,there was no surface
discharge evident. The existing septic system is a code system for a three bedroom home.
The city setback for a well to a septic tank is seventy-five feet. The minimum state code setback
to a septic tank is fifty feet. The existing tanks are fifty-nine feet from the first septic tank.
While this does not meet the city code, it does meet the state minimum standards for well
setbacks.
Staff recommends approving a variance for a well setback to be fifty-nine feet from a well due to
the fact the septic system is a code system and would induce a hardship that could be avoided.
This variance will stand unless the existing septic tanks would need to be replaced, at which time
the new septic tanks would need to meet all necessary setbacks.
CITY OF ORONO � O�
Municipal Offices O O
Post Office eox 66
Crystal eay, MN 55323-0066 � � ON-SITE SEWAGE TREATMENT
r�`, � INSPECTION REPORT
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9kESHa�'�
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Owner: .��/�I�E- ��2r�`�/C1 Address: �J(�V SiX't7/t j�V� /�,
Permit �'s: �'" Dates:�� ,.�7��"1���Contractors: YV l G�'Y"IL•;� �f)�'1J.5,
City ordinance nunber 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site seuage 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)
EM CONFORMITY 1-3 : /
--f—
1 "CODE SYSTEM"-A system which meets all the tocation, 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 poltutants 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 aas 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 tocated 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 uhich is failing for any reason; and any system uith less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soit characteristics.
(The limiting soil characteristic�has or [ ] has not been identified at this time. [f the limiting soil
characteristic has not been ident fi this classification may be subject to revision.)
TANK CONDITION 5-10 :
nspection indicate :
umpout not needed at this time.
Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accumulation 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 etiminate surface dischar�e.
9 Inspection risers missing-tanks could not be inspected. Inspection risers (4" dia. pipe) rtx�st be installed in each
tank at next pumpout. ]f tanks have not been punped out uithin the last three years, they should be pur�ped
out now.
10 ]nspection pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been punped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14):
infie d inspection indicates:
11 infield 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
irtmediately. Repairs must be completed uithin 90 days.
14 Drainfield extent and condition unknoun.
LIMITING SITE FACTORS (slope,setbacks,etc.): �(p
POTENTIAL FOR SYSTEM FAILURE (depends on soils.water table,etc.): I���
-- r
COMMENTS: ' ,i -f- � � � �� •, � ?
•t �J ti, � S° S'- �
�
Date of Inspec 'on e 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 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 location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
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'' '�'� CITY of ORONO
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,�',, �``�,`�'�4 �!� �� Municipal Offices
�.�'�' �;��°� �`����G Street Address: Mailing Address:
9$'EggOg' 2750 Kelley Parkway P.O. Box 66
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CITY OF ORONO � O�
Municipal Offices O O
Post Office Box 66
Crystal Bay, MN 55323-0066 � � ON—SITE SEWA(�E TREATl�:NT
r$`,� �, INSPECTION REPORT
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Owner: ^/�JI�llA1'Y� �Y1��� Address: crCJi� .sIX.7f� �ii/+��. /l/,
Permit �'s: 7��� Dates: D'"��6� Contractors: �,f J1L71y►ei�,d 1rl,1�
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 [ ] new construction)
SYSTEM CONFORMITY 1-3 :
"CODE SYSTEM"-A system which rt�eets all the location, design, and construction standards of the current City
Codes, arxi 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 uhich 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 700-year floodplai�; 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 sotl characteristics.
(The limiting soil characteristic ,�]. has or [ ] has not been identified at this time. If the limiting soil
characteristic has not been identi�ied, this classification may be subject to revision.)
TANK CONDITION (5-10):
Tank inspection indicates:
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pu�ed out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be ptmped out as soon as possible.
� System is discharging to the surface. Tanks must be punped out within 48 hours to eliminate surface dischar�e.
Inspection risers missing-tanks could not be inspected. I ' ' ' in each
.;ank at next_�s1t. If tanks have not been out within t e ast t ree years, t ey s ou
� noW.
10 Inspec i`� on pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been punped out within the last three years, they should be punped out now.
DRAINFIELD CONDITION (11-14):
DqB�field inspection indicates:
V.Y Draintield is dry, no surfacing evident.
12 Some evidence of surtacing, 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 S1TE FACTORS (slope,setbacks,etc.): /��T'
` L�La�
POTENTIAL FOR SYSTEM FAILURE (deaends on soils.Water table,etc.):
COMM NTS:���,� -�,�-�r� ��,� r�e s�- Q>�-���,�,/,� be �,�1
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 certify that an existing system Will continue to function
properly� but is merely an optnton 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 locetion and p�ing 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 ��o� ����'►')ar�- ADDRESS ��UC7 l�.f �vi-� /1/1
PERMIT NO.'S. �7� DATES ��Z�7 CONTRACTORS �•
City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The onsite sewage
treatment system at the above address has been inspected and appears to fall i�to the category checked below.
(This is � an existing system ❑ new construction)
�� Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
� 2 Does not meet all current City standar� for new �nstruction (1978 Code) but in most respects appears to be designed,
located, and constructed ge�erally 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 many respects relating to design,conatruction,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: ❑ lnspection pipe is loceted directly over tank baffle.(Does not
❑ Pumpout not needed at thia time. give accurate measurement of solids eccumulation.) If tanks
❑ Solids accumulation in tenks 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.
❑ System is discharging to surface. Tanks must be pumped ❑ Some evidence of surfacing,not critical yet.
� withi�48 hours to eliminate surface discharge. ❑ Drainfield is saturated and visibly discharging untreated
�.Inspection risers missing—tanks could not be inapected. effluent to the surface. This condition may require replace-
Inspection risera (4"dia. pipe)must be installed in each tank ment or edditions to drai�field. 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 Futu e Expansion
❑ Soil table and system condition) �dequate
�High water table �Low ❑ Fair
Lot size Medium ❑Poor
❑ Lake,wetland,or stream ❑ High � Inadequate
❑ Drainage ❑System is causing visible
surf ce discharge.
COMMENTS: ' �~�� � �� "' O�
��L-J
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 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