HomeMy WebLinkAboutSeptic Compliance Inspection Form Minnesota Pollution Compliance Inspection Form
Control Agency
Existing Subsurface Sewage Treatment Systems
520 Lafayette Road North
St.Paul,MN 55155-4194 (SSTS)
Doc Type:Compliance and Enforcement
Instructions: Inspection results based on Minnesota Pollution Control Agency(MPGA) For local tracking purposes:
requirements and attached forms—additional local requirements may also apply.
Submit completed form to Local Unit of Government(LUG)and system owner
within 15 days
System Status
System status on date(mm/dd/yyyy): 4/26/2018
/1 Compliant—Certificate of Compliance ❑ Noncompliant— Notice of Noncompliance
(Valid for 3 years from report date, unless shorter time (See Upgrade Requirements on page 3)
frame outlined in Local Ordinance.)
Reason(s)for noncompliance(check all applicable)
❑ Impact on Public Health(Compliance Component #1)—Imminent threat to public health and safety
❑Other Compliance Conditions(Compliance Component#3)—Imminent threat to public health and safety
❑Tank Integrity(Compliance Component #2)—Failing to protect groundwater
0 Other Compliance Conditions(Compliance Component#3)—Failing to protect groundwater
❑Soil Separation(Compliance Component #4)—Failing to protect groundwater
❑Operating permit/monitoring plan requirements(Compliance Component #5)—Noncompliant
Property Information Parcel ID#or Sec/Twp/Range: 3011823430004
Property address: 885 Hunt Farm Road, Orono,MN Reason for inspection: Property Transfer
Property owner: Peter Passolt Owner's phone: 612-991-2442
or
Owner's representative: Representative phone:
Local regulatory authority: Cityof Orono Regulatory authority phone: 952-249-4600
2-1300 gallon septic tanks,1-1300 gallon lift station and 500 square feet of mound rockbed.Filter in the
Brief system description: second tank.
Comments or recommendations:
TBM: Bottom of the rock bed. 1.5 feet of sand under the rock bed.The tanks were last pumped on 5/2/16 This compliance report is
valid until 5/02/19
Certification
1 hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No
determination of future system performance has been nor can be made due to unknown conditions during system construction,
possible abuse of the system, inadequate maintenance, or future water usage.
Inspector name: Joseph J Olson Certification number: 1255
Business name: Rusty OI n's Soil !'arc-Testing License number: 810
Inspector signature: Phone number: 763-498-8779
Necessary or Locally Required Attachments
®Soil boring logs ® System/As-built drawing 0 Forms per local ordinance
0 Other information(list):
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wq-wwists4-31 • 1/24/12 Page 1 of 3
Property address: 885 Hunt Farm Road,Orono,MN Inspector initials/Date: J. O.4/26/18
1. Impact on Public Health -Compliance component#1 of 5
Compliance criteria: Verification method(s):
System discharge sewage to the 0 Yes ® No ® Searched for surface outlet
ground surface. ® Searched for seeping in yard/backup in home
❑ Excessive ponding in soil system/D-boxes
System discharge sewage to drain tile 0 Yes ® No
or surface waters. ❑ Homeowner testimony(See Comments/Explanation)
"Black soil"above soil dispersal system
System cause sewage backup into 0 Yes Z No ❑ System requires"emergency"pumping
dwelling or establishment.
__. 0 Performed dye test
Any"yes"answer above indicates the system is 0 Unable to verify(See Comments/Explanation)
an Imminent Threat to Public Health and Safety. ❑ Other methods not listed (See Comments/Explanation)
Comments/Explanation:
2. Tank Integrity-Compliance component#2 of 5
Compliance criteria: Verification method(s):
System consists of a seepage pit, ❑Yes ® No 0 Probed tank(s)bottom
cesspool,drywell,or leaching pit. ® Examined construction records
Seepage pits meeting 7080.2550 maybe ❑ Examined Tank Integrity Form(Attach)
compliant if allowed in local ordinance.
0 Observed liquid level below operating depth
Sewage tank(s)leak below their 0 Yes t.1 No ❑ Examined empty(pumped)tanks(s)
designed operating depth.
0 Probed outside tank(s)for"black soil"
If yes,which sewage tank(s)leaks:
0 Unable to verify(See Comments/Explanation)
Any "yes"answer above indicates the s Other methods not listed(See Comments/Explanation)
system is Failing to Protect Groundwater.
Comments/Explanation:
The tanks were last pumped on 5/02/16.The baffles are in place and the tanks are operating at there designed depth.
3. Other Compliance Conditions-Compliance component#3 of 5
a. Maintenance hole covers are damaged,cracked,unsecured,or appear to structurally unsound. ❑Yes* ®No ❑Unknown
b. Other issues(electrical hazards.etc.)to immediately and adversely impact public health or safety. ❑Yes* 0 No 0 Unknown
*System is an imminent threat to public health and safety
Explain:
c. System is non-protective of ground water for other conditions as determined by inspector 0 Yes* 0 No
*System is failing to protect groundwater
Explain:
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•
Property address: 885 Hunt Farm Road, Orono, MN Inspector initials/Date: J. 0.4/26/18
4. Soil Separation —Compliance component#4 of 5
Date of installation: 11/17/2010 ❑ Unknown Verification method(s):
ShorelandlWellhead protection/Food Beverage ®Yes ❑ No Soil observation does not expire. Previous soil
Lodging? observations by two independent parties are sufficient,
Compliance criteria: unless site conditions have been altered or local
requirements differ.
For systems built prior to April 1, 1996, and ❑Yes ❑ No
not located in Shoretand or Wellhead ® Conducted soil observation(s)(Attach boring logs)
Protection Area or not serving a food, ❑ Two previous verifications(Attach boring logs)
beverage or lodging establishment:
0 Not applicable(Holding tank(s).no drainfield)
Drainfield has at least a two-foot vertical 0 Unable to verify(See Comments/Explanation)
separation distance from periodically
saturated soil or bedrock. ❑ Other(See Comments/Explanation)
Non-performance systems built April 1, ®Yes ❑No Comments/Explanation:
1996, or later or for non-performance
systems located in Shoretand 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 depths of elevations
systems built under pre-2008 Rules; Type IV
or V systems built under 2008 Rules(7080. A. Bottom of distribution media 100.0
2350 or 7080.2400 (Advanced Inspector
License required) B. Periodically saturated soil/bedrock 97.0
Drainfield meets the designed vertical C. System s paration 3.0
separation distance from periodically
saturated soil or bedrock.
D. Required compliance separation* 2.6
Any "no"answer above indicates the system is *May be reduced up to 15 percent if allowed by Local
Failing to Protect Groundwater. Ordinance.
5. Operating Permit and Nitrogen BMP*-Compliance component#5 of 5 Not applicable
Is the system operated under an Operating Permit? ❑Yes ❑ No If"yes",A below is required
Is the system required to employ a Nitrogen BMP? 0 Yes ❑ No If"yes", B below is required
BMP=Best Management Practice(s)specified in the system design
If the answer to both questions is "no", this section does not need to be completed.
Compliance criteria
a. Operating Permit number:
Yes 0 No
Have the Operating Permit requirements been met?
b. Is the required nitrogen BMP in place and properly functioning? ❑Yes ❑ No
Any "no"answer indicates Noncompliance.
Upgrade Requirements(Minn. Stat.§115.55)An imminent threat to public health and safety(ITPHS)must be upgraded.replaced,or its use
discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. If the system is failing to protect
ground water, the system must be upgraded, replaced,or its use discontinued within the time required by local ordinance. If an existing system
is not failing as defined in law,and has at least two feet of design soil separation, then the system need not be upgraded,repaired,replaced, or
its use discontinued,notwithstanding any local ordinance that is more strict. This provision does not apply to systems in shoreland areas,
Wellhead Protection Areas,or those used in connection with food,beverage,and lodging establishments as defined in law.
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Soil Observation Log
0,0 o.SepticResource.comvers 12.4
Owner Information
Property Owner/project: Peter Passolt Date 4/26/2018
Property Address PID: 885 Hunt Farm Road
Soil Survey Information ❑refer to attached soil survey
Parent matl's: L11 Till E Outwash ❑ Lacustrine ❑Alluvium ❑Organic L Bedrock
landscape position: El Summit ❑ Shoulder [' Side slope ❑Toe slope
soil survey map units: L411)2 slope % direction-
Soil Log#1
2 Boring ❑Pit Elevation 99.5 Depth to SHWT 30 Inches
Depth(in) Texture fragment% matrix color redox color consistence grade shape
0-12 Fill <35
12-20 Topsoil <35 10yr3/2 Loose Moderate Blocky
20-30 Clay Loam <35 I0yr4/4 Friable Strong Blocky
30-40 Clay Loam <35 10yr5/4 10y4/8.1-6/10y Firm Strong Blocky
loose loose
<J5 single grain
friable weak granular blocky
35 - 50
firm moderate prismatic plat
=>50
rigid strong massive
Comments:
885 Hunt Farm Road Soil Log#2
0 Boring ❑ Pit Elevation 100.2 Depth to SHWT 36 Inches
Depth(in) Texture fragment% matrix color redox color consistence grade shape
0-16 Fill
16-24 Topsoil - ; I0yr3/2 Loose Moderate Blocky
24-36 Clay Loam ':35 l 0yr4/3 Friable Strong Blocky
36-42 Clay Loam <35 1tt r5 3 10y4/8.1-6/l0y Firm Strong Blocky
<35 loose loose single grain
friable weak granular blocky
35-50
>50 firm moderate prismatic plate
rigid strong massive
885 Hunt Farm Road Soil Log#3
E Boring ❑ Pit Elevation Depth to SHWT
Depth(in) Texture fragment% matrix color redox color consistence grade shape
<35 loose loose single grain
friable weak granular blocky
35-50
>50 firm moderate prismatic plate
rigid strong massive
<35 loose IOOSe single grain
friable weak granular blocky
35-50
>50 firm moderate prismatic plan
rigid strong massive
loose loose
35 single grain
friable weak granular blocky
35 -50
>50 firm moderate prismatic platy
rigid strong massive
<35 loose loose single grain
friable weak granular blocky
35-50
>50 firm moderate prismatic platy
rigid strong massive
loose loose
<35 single grain
friable weak granular block
35-50
>50 firm moderate prismatic platy
rigid strong massive
I hereby certify this work was completed in accordance with MN 7080 and any local rey's.
Rusty' Olson's Soil & Perc 810
esigner Signature Company License 4
SEPTIC SYSTEM INVENTORY
Site Address: 885 Hunt Farm Rd PID 30-118-23-43-0004
Owner Name: Peter Passolt&Amy Akers-Passolt
Owner Address: 885 Hunt Farm Road Long Lake MN 55356-
BuildingType: residence Installer: Hayes and sons
Date of Permit: 11/09/10
System Type: mound BR's Designed for 4
In Musa?: No Shoreland?: No
SEPTIC TANKS:
Material: precast concrete Capacity: 1300, 1300, 1300 Tank Filter: yes
DRAINFIELD:
Treatment Area: 500 Soil Boring: yes DF Ht above Wt: 3
WELL DATA
Setbacks -Well Tanks: Well DF: Report In File: Depth:
INSPECTION RECORDS PUMPOUT RECORDS -
Date Notes Date GallonsOfLiquid
11/17/2010 New mound system I 5/2/2016
7/1/2007 OK 2700
5/6/2013 3000
6/2/2005 OK 11/17/2010 2000
8/18/2003 no surfacing 5/15/2006 1200
8/9/2001 no surfacing,cap insp pipe 5/20/2004 2500
9/27/1999 code system, no surfacing 5/9/2002 3000
6/11/1997 no surfacing
5/25/1999 2000
4/19/1996 no surfacing-pump tanks 6/9/1997 2000
5/5/1993 no surfacing 5/20/1996 2000
7/16/1991 no surfacing 9/3/1993 2000
9/17/1990 no surfacing 6/1/1990 2000
9/30/1988 no surfacing 6/1/1990 2000
9/18/1986 no surfacing
11/12/1981 installation
I 11/12/1981 installation
•
12 12 09: 29p Brad 7636820977 p. 6
CITY OF .......,CMON 0
WORKSHEET FOR SEWAGE DISPOSAL WORK
lnspectorjg• 1,,�._. ' l'b 5 Building Permit No.
Owner Pe, - GIS So i + .
Property Address_ P 5 1- L./4,v Farm CZcL
Kind of Building 5 PO
SSTS Installer_ 14 4,1 5 a,^,.5 License* L (0 4/4
Septic Tanks
Material C ¢t e_ (C)4+e wi i"- Number of Tanks, 3
size 13 4U 1 1 3 OO , 13 GCS 1112--r— .
Drain
,"r--r--
Drain old: i
Total length of lines 4 Number of fines
'Type of soil f t.c,� Percolation Test Is2.a.-t-4 0.l5
Width of trench, ' --- Type of flibm' l Co b vit.
Size of Rock Bed j 0 Size of Absorption Area
Draw detailed diagram with measurements indlcating distances to septic**risers from a
permanent structure.
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